Alvarado Score is a Helpful Tool to Improve Outcomes of Acute Appendicitis at Lampang Regional Hospital
Keywords:
Pending, Alvarado ScoreAbstract
Background: The diagnosis of acute appendicitis is still problematic due to various stages of clinical presentation. Alvarado Score is one of the tools expected to help the diagnosis and our institute has used it as appendicitis protocol since October 2016. We aimed to assess the usefulness of Alvarado Score.
Methods: Cross-section study was carried out in all patients who underwent appendectomy at the Lampang Regional Hospital between October 2013 and December 2016. Data were compared and analyzed between “Alvarado Assessment” group (AA group) and “No Assessment” group (NA group).
Results: Alvarado score was used more frequently in a period after October 2016 compared to a prior period (72.9:17.7 %, p < 0.01). A total of 5,087 patients were included, with 45.7% of men and 54.3% of women. In the AA group, appendectomy was performed earlier (operation performed within 24 hours = 98.8% vs. 97.1%; P < 0.01), length of stay was shorter (mean +SD = 2.8 ± 1.53 vs. 3.1 ± 2.34 days, P < 0.01), perforation rate was lower (5.8% vs. 12.2%, P < 0.01) and the negative appendectomy rate (NAR) was lower (23.8% vs. 30.4%, P < 0.01) compared to the NA group. However, there were no differences in surgical site infection and mortality rate.
Conclusion: Advantages of Alvarado assessment included support of correct diagnosis, easier decision making resulting in faster time to operate and better clinical outcomes.
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