2018•Annals of African SurgeryOpen access

Alvarado vs Lintula Scoring Systems in Acute Appendicitis

Daniel Kinyuru Ojuka, Mike Sangoro

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Abstract

Background: Timely and correct diagnosis of acute appendicitis reduces complications and avoids unnecessary surgeries. Scoring systems are used as adjuncts to aid in diagnosis.Methods: This was a prospective observational study carried out at Kenyatta National Hospital, from November 2014 to April 2015. Demographic, clinical and laboratory data was collected from consenting patients. The gold standard of diagnosis was histopathology. Data analysis was done using SPSS. The receiver operating characteristics, sensitivity, specificity, positive predictive values and negative predictive values of both scoring systems were then calculated for each of the scoring systems and compared between the two.Results: Majority of patients presented with right iliac fossa pain and underwent appendectomy. The sensitivity of the Lintula and Alvarado scoring systems were 60.8% and 84.3% respectively, while the specificity was 60% and 35% respectively. The PPV of the Lintula was 79.5% while that of the Alvarado 76.8%.Conclusion: The Lintula system compares well with the Alvarado system for diagnosis of acute appendicitis and can therefore be employed in situations where laboratory facilities may be limited.Key words: Acute Appendicitis, Scoring systems, Lintula, Alvarado

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Background: Timely and correct diagnosis of acute appendicitis reduces complications and avoids unnecessary surgeries. Scoring systems are used as adjuncts to aid in diagnosis.Methods: This was a prospective observational study carried out at Kenyatta National Hospital, from November 2014 to April 2015. Demographic, clinical and laboratory data was collected from consenting patients. The gold standard of diagnosis was histopathology. Data analysis was done using SPSS. The receiver operating characteristics, sensitivity, specificity, positive predictive values and negative predictive values of both scoring systems were then calculated for each of the scoring systems and compared between the two.Results: Majority of patients presented with right iliac fossa pain and underwent appendectomy. The sensitivity of the Lintula and Alvarado scoring systems were 60.8% and 84.3% respectively, while the specificity was 60% and 35% respectively. The PPV of the Lintula was 79.5% while that of the Alvarado 76.8%.Conclusion: The Lintula system compares well with the Alvarado system for diagnosis of acute appendicitis and can therefore be employed in situations where laboratory facilities may be limited.Key words: Acute Appendicitis, Scoring systems, Lintula, Alvarado

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Available abstract

Background: Timely and correct diagnosis of acute appendicitis reduces complications and avoids unnecessary surgeries. Scoring systems are used as adjuncts to aid in diagnosis.Methods: This was a prospective observational study carried out at Kenyatta National Hospital, from November 2014 to April 2015. Demographic, clinical and laboratory data was collected from consenting patients. The gold standard of diagnosis was histopathology. Data analysis was done using SPSS. The receiver operating characteristics, sensitivity, specificity, positive predictive values and negative predictive values of both scoring systems were then calculated for each of the scoring systems and compared between the two.Results: Majority of patients presented with right iliac fossa pain and underwent appendectomy. The sensitivity of the Lintula and Alvarado scoring systems were 60.8% and 84.3% respectively, while the specificity was 60% and 35% respectively. The PPV of the Lintula was 79.5% while that of the Alvarado 76.8%.Conclusion: The Lintula system compares well with the Alvarado system for diagnosis of acute appendicitis and can therefore be employed in situations where laboratory facilities may be limited.Key words: Acute Appendicitis, Scoring systems, Lintula, Alvarado

Key concepts: Medicine, Alvarado score, Acute appendicitis, Observational study, Gold standard (test), Scoring system, Iliac fossa, Appendicitis

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