Naeem Liaqat, Asif Iqbal, Wajeeh-ur Reham, Zulfiqar Ahmed, Fozia Bashir, Sajid Hameed Dar.
Comparison of Alvarado Score and Paediatric Appendicitis Score for Diagnosing Appendicitis in Children.
Esculapio J Services Inst Med Sci Jan ;17(2):176-9.

Objective: To compare diagnostic accuracy of Alvarado score (AS) and Paediatric Appendicitis Score (PAS) for diagnosis of acute appendicitis in children. Methods: This study was conducted at the department of Pediatric Surgery Children Hospital Lahore, over a period of 1 year. All the patients undergoing appendicectomy were included. Alvarado score and Pediatric Appendicitis score (PAS) was evaluated, compared and appendix specimen sent for histopathology. All findings were recorded in proforma. The collected data was analyzed by SPSS version 24. The mean Alvarado score and PAS was calculated, and stratified according to the histopathology reports. The sensitivity and specificity of both Alvarado score and PAS for three strata including score 3-5, 5-7 and 8-10 were also calculated. Results: A total of 177 patients were included in the study. The mean age of the patients was 9.16 +- 2.386 years. Among these 118 patients (67%) were male. The mean duration of pain was 21.42 +- 19.05 hours. Biopsy report showed that 18 patients (10.1%) had normal appendix with no signs of inflammations while 159 patients (89.9%) had inflammation on histopathology. We stratified the histopathology reports according to Alvarado score <=7 and >7 and P-vale was found significant. Similarly PAS <=7 and >7 was stratified and P value was not significant. The difference in mean Alvarado score between having acute appendicitis and those with normal histopathology was significant (P= 0.000) while this difference in mean PAS was not found significant (P= 0.325). Conclusions: None of the scoring system has adequate diagnostic accuracy and clinical judgment is preferred.

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