EVALUATION OF THE DIAGNOSTIC ACCURACY OF ALVARADO SCORE AS COMPARED TO ABDOMINAL ULTRASONOGRAPHY: A ONE YEAR REVIEW OF ACUTE APPENDICITIS PATIENTS OPERATED AT ST. PAUL’S HOSPITAL MILLENNIUM MEDICAL COLLEGE

Abstract

Summary Background The decision to operate patients with diagnostic impression of appendicitis still poses a challenge worldwide notwithstanding the advances in modern radiographic imaging and diagnostic laboratory investigation. Differences in diagnostic accuracy have been observed by using clinical scores and imaging for appendicitis among various populations and clinical settings. [13,14,17] Objectives The objective of this study is to evaluate the diagnostic accuracy of Alvarado score as compared to abdominal ultrasonography in acute appendicitis patients operated in SPHMMC in the year 2017. Methods A hospital based analytic retrospective study will be carried out on a study population of 461 acute appendicitis patients operated in 2017 at SPHMMC. Simple random sampling technique will be used to select 210 of them for fair representation. A pretested checklist consisting of sociodemographic profile, Alvarado score parameters, abdominal ultrasonography and intraoperative findings will be used to collect the required data from medical charts. These will be entered into a computer and analyzed using SPSS statistical software. Chi-square tests and multivariable logistic regression with 95% CI at P ≤ 0.05 and the area under the curve will be used to determine the diagnostic accuracies. The research is to be completed in the time frame from February to July 2018 with total cost of the project estimated as 4,439.60 Birr. Result From the total number of 210 patients that will be studied in the research, the pattern of appendicitis will be determined by age and sex with the type of operation undertaken. The intraoperative finding consistent with appendicitis and its complications will be identified. This shall be used to determine retrospectively the sensitivity, specificity, positive and negative predictive value of Alvarado score and abdominal ultrasonography in reaching the accurate diagnosis of appendicitis. Conclusion The research will determine the accuracy of Alvarado score and abdominal ultrasonography for the better selection of a diagnostic approach with maximal sensitivity in time and cost efficient manner in acute appendicitis patients. And subsequently reduces negative appendectomy and complication rates. Key words: Appendicitis, Alvarado score, Abdominal ultrasonography, SPHMMC.