Hande KÖKSAL, Rıza SARIBABIÇÇI, Bülent UYSAL

The role of the alvarado scoring system and ultrasonography in the diagnosis of acute appendicitis

Amaç: Alvarado skor sistemi ve ultrasonografinin akut apandisit (AA) tanısında rolü ve prediktif değerinin saptanması. Gereç ve Yöntem : Kliniğimizde 2008 yılı içinde AA ön tanısı ile ameliyat edilmiş hastalar retrospektif olarak değerlendirildi. Klinik tanı öykü, fizik muayene, laboratuar ve radyolojik bulgular ile yapıldı. Alvarado skorları ve ultrasonografi bulguları hastaların dosyalarından elde edildi. Bulgular: 2008 yılı içinde, kliniğimizde 581 hasta AA ön tanısı ile ameliyat edildi. Dosyasından hem Alvarado skoru hem de ultrasonografi bilgilerine ulaşılabilen 184 hasta retrospektif olarak incelendi. Hastaların 95'i erkek, 89'u kadın olup, ortanca yas 24 yıl idi (aralık 14-78 yıl). 171 hastada (%93) patolojik olarak AA tanısı konulurken, 13 hastada (%7) AA saptanmadı. Alvarado skorunun duyarlılık, özgüllük, pozitif tanımlama oranı, negatif tanımlama oranı ve doğruluk oranı sırasıyla, %56, %69, %96, %89, ve %56; Ultrasonografinin duyarlılık, özgüllük, pozitif tanımlama oranı, negatif tanımlama oranı ve doğruluk oranı sırasıyla %52, %38, %92, %94, ve %51; hem Alvarado skorunun hem de ultrasonografinin duyarlılık, özgüllük, pozitif tanımlama oranı, negatif tanımlama oranı ve doğruluk oranı sırasıyla %58, %51, %94, %89 and %58 idi. Sonuç: Semptom, klinik ve laboratuar bulgularına dayanan Alvarado skor sistemi ile ultrasonografi AA tanısında yardımcıdır.

Akut apendisit tanısında alvarado skor sistemi ve ultrasonografinin rolü

Purpose: To determine the role and predictive value of the Alvarado scoring system and ultrasonography in the diagnosis of acute appendicitis (AA)' Materials and Methods: This study is a retrospective review of all patients who underwent appendectomy for presumed AA in our clinic in 2008. The clinical diagnosis was established preoperatively based on clinical history, physical examination, laboratory tests, and radiologic findings. The patients' Alvarado scores and ultrasonography findings were obtained from their medical records. Results: In 2008, 581 patients underwent appendectomy for presumed AA. Of these, 184 patients with both preoperative ultrasound and Alvarado scores were evaluated. There were 95 male and 89 female patients with a median age of 24 years (range, 14-78). While 171 patients (93%) had AA, 13 patients (7%) did not. The sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic value of the Alvarado score were 56%, 69%, 96%, 89%, and 56%, respectively. The sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic value of ultrasonography were 52%, 38%. 92%, 94%, and 51%, respectively. The sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic value of both the Alvarado score and ultrasonography were 58%, 51%, 94%, 89%, and 58%, respectively. Conclusion: The Alvarado scoring system, based on symptoms, clinical signs and laboratory findings, and/or imaging studies, especially ultrasonography, is helpful for diagnosing AA.

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