Validation of ultrasound combined modified Alvarado scoring system in acute appendicitis patients

Supreeth kumar reddy Kunnuru; Selvapriya Bharathi; Manuneethimaran Thiyagarajan; Balaji Singh K; Arulappan.T

Volume : IX, Issue : VII, July - 2020

Validation of ultrasound combined modified Alvarado scoring system in acute appendicitis patients

Supreeth Kumar Reddy Kunnuru, Selvapriya Bharathi, Manuneethimaran Thiyagarajan, Balaji Singh K, Arulappan. T

Abstract :

Objectives: Acute appendicitis, though one of the common emergencies in surgical practice, at times can confuse the best clinicians. There are lot of scoring system used to diagnose the appendicitis. We used Combination of USG abdomen with Modified Alvarado scoring system to make UcMASS and was compared with Histopathology reports to identify the sensitivity and specificity. Material and methods: Totally 120 patients with clinically suspected appendicitis patients were included in our study. Although decision making was not done based on Uc MASS , study was conducted and data were collected simultaneously .Comparison was done with confirmatory histopathology reports and cross table was made with two groups of UcMASS(group 1 score seven and above, group 2 score <7). Sensitivity specificity, PPV and NPV were collected. Results: Maximum number of patient included in our study belongs to 21- 30 yrs of age group (53.3%). Out of 120 patients in the study 90(75%) patients were male and 30(25%) were female (with M: F ratio of 4:1). Out of 120 patients 96 (80%)patients score was above 7 in which histopathological report was positive for 83(69%) patients and rest of 13 (10.8%) only histopathology negative patients. Out of 120 patients 24(20%) patients score was below 7 in which histopathological report was negative for 23(19.1%) patients. This is Statistically significant with p value < .001 = 99.9% significant. Sensitivity of the Uc MASS in appendicitis is 98.8% And Specificity is 63.8 %. . Its Positive Predictive Value is 86.4% Negative Predictive Value is 95.8% Conclusion: In this study,the diagnostic score may be used as a guide to evaluate the patients need for surgery or observation. so we conclude that UcMASS can be used routinely to diagnose the acute appendicitis and decision making can be done on score basis.