ANALYSIS OF DIAGNOSTIC PERFORMANCE OF ALVARADO SCORE AND ULTRASOUND IN PATIENTS HAVING ACUTE APPENDICITIS

Background: Acute appendicitis is a surgical emergency and delay in diagnosis can lead to morbidity of the patient. CT despite of being gold standard investigation carry radiation hazards and risk of cancer. Objective: To evaluate diagnostic reliability of Alvarado score and ultrasound in patients who have suspicion of having acute appendicitis to get to a safe diagnosis without radiation exposure. Material & Methods: This is a retrospective study conducted on 100 patients who presented in emergency with presumed acute appendicitis at Lahore General hospital during 2019. Results: Using a cutoff value of ≥5.5 Alvarado score resulted in sensitivity of 76%, specificity of 93%, accuracy of 84%, PPV 94%, and NPV 73%. US showed a sensitivity of 66%, specificity of 97.6%, accuracy of 79%, PPV 97% and NPV 67%. There was no difference of accuracy between the two modalities. Using both of these modalities can eliminate the use of CT scan. Conclusion: Using Alvarado score as tool of exclusion and US as 1st investigation of choice, a case of acute appendicitis is not only diagnosed correctly but also radiation hazards of CT scan can be eliminated