IMPORTANCE OF ALVARADO SCORE IN MAKING THE TREATMENT PLAN AND DIAGNOSIS OF ACUTE APPENDICITIS

Objective: To reduce the rate of negative appendectomy and perforation risk by using the Alvarado score as an admission criterion and management plan for acute appendicitis. Study design: Interventional study. Place and Duration: In the Surgical Unit of Aziz Bhatti Shaheed Teaching Hospital Gujrat. for One year duration from April 2018 to April 2019. Methodology: This study was based on data that the use of the Alvarado scoring system was evaluated prospectively in 140 sequential patients of above twelve years of age with right iliac fossa pain and with or without acute abdominal features. Results: 140 total patients were selected for the study, male were 95 (67.8%) and females were 45 (32.1%). 1.5: 1 was the male / female ratio. Of the 140 cases, Alvarado score was 4 or less in 28 (20%), were discharged and were scheduled for follow up at the outpatient clinic after 24 hours. For observation of cases having Alvarado score 5-6, 43(30%) patients were admitted, 9 (20.9%) of patients show improvement and appendectomy was done in 34 (79%) due to Alvarado Score rise up to 7. Sixty nine patients have above seven Alvarado score. The appendectomy was done in all of them. In 22 patients (31.8%); gangrenous or perforated appendix was noted. In general, the negative appendectomy rate was 3 male and 6 patients were female (9% (8.5%)). Conclusion: In acute appendicitis, the Alvarado score can be used as an objective criterion in the selection of patients receiving admission and conservative or operative treatment. In women, a complementary ultrasound should be performed on the abdomen and pelvis to exclude other pathologies.