Diagnostic Accuracy of Alvarado Score In Comparison With Raised C-Reactive Protein Levels For Acute Appendicitis

Khadija A Rehman, Tunza Irfan, Kainat Zafar, Muhammad Naeem, Mazhar Iqbal, Aazma Mirza

Abstract

Objective

To find out the diagnostic accuracy of Alvarado score in comparison with raised C-reactive protein (CRP) levels for acute appendicitis considering histopathological findings as gold standard.

Study design

Cross sectional study.

Place & Duration of study

Department of •Surgery Unit II, Jinnah Postgraduate Medical Centre (JPMC) Karachi, from August 2022 to August 2024.

Methods

Patients of either gender above 12-years of age were included. A detailed history was taken and physical examination performed. C-reactive protein level estimation was done along-with CBC and urine D/R. All patients underwent surgery and appendectomy done. Specimen was sent for histopathology. Descriptive statistics were used to report quantitative data as mean with standard deviation and qualitative variables as frequency and percentages. Sensitivity, specificity, positive and negative predictive values with diagnostic accuracy were computed for Alvarado score and CRP level.

Results

A total of 369 patients were included. Mean age of the patients was 41.90 ±8.82 years. There were 216 males and 153 females. Alvarado score had a sensitivity of 85.7%, specificity 83%, positive predictive value 62.4%, negative predictive value 94.6%, and diagnostic accuracy 83.7%. CRP levels had sensitivity of 59.3%, specificity 88.8%, positive predictive value 63.5%, negative predictive value 86.6%, diagnostic accuracy of 81.5%.

Conclusion

Alvarado score had a better diagnostic accuracy in comparison with CRP levels.

Key words

Acute appendicitis, Alvarado score, CRP level, Diagnostic accuracy.