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Published in: European Journal of Trauma and Emergency Surgery 3/2019

01-06-2019 | Original Article

The Alvarado Score is accurate in pregnancy: a retrospective case–control study

Authors: F. Tatli, Y. Yucel, O. Gozeneli, A. Dirican, A. Uzunkoy, H. C. Yalçın, A. Ozgonul, O. Bardakci, H. Uyanikoglu, A. İncebiyik

Published in: European Journal of Trauma and Emergency Surgery | Issue 3/2019

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Abstract

Background

Acute appendicitis is the most frequent abdominal condition that requires non-obstetric surgical intervention during pregnancy. This study aims to scan pregnant patients operated on for acute appendicitis to evaluate the efficiency of using the Alvarado Score (AS) for diagnosis.

Methods

Our study included 48 pregnant patients who were pre-diagnosed with acute appendicitis and operated on at our department of general surgery from January 2010 to July 2016 and whose files were accessed. Fifty-three non-pregnant female patients of reproductive age who were operated on for appendicitis during the same period were included in the study as the control group. The patients in both groups were divided into two groups based on their AS total score being 7 and ≥ 7.

Results

The mean age of the 48 pregnant patients was 28 (19–42) years, while the mean age of the 53 control patients was 31 (18–45) years. Among pregnant and non-pregnant women, about a third of patients had an AS < 7 (16 of 48 versus 18 of 53). There was no significant difference when the AS scores of both groups were compared (p = 0.947). Using pathology results as reference test, the sensitivity and specificity of the AS in pregnant women was 79 and 80%.

Conclusions

As a result, when the data collected by our study are evaluated, we see that pregnancy does not have a negative effect on the efficacy of AS. Therefore, the AS system can be an easy, non-invasive auxiliary diagnostic tool with high diagnosis accuracy rates that can be used in pregnant patients suspected of having acute appendicitis.
Literature
1.
go back to reference Kort B, Katz VL, Watson WJ. The effect of non obstetric operation during pregnancy. Surg Gynecol Obstet. 1993;177:371–6.PubMed Kort B, Katz VL, Watson WJ. The effect of non obstetric operation during pregnancy. Surg Gynecol Obstet. 1993;177:371–6.PubMed
2.
go back to reference Segev L, Segev Y, Rayman S, Nissan A, Sadot E. Acute appendicitis during pregnancy: different from the nonpregnant state? World J Surg. 2016;16:3731–7. Segev L, Segev Y, Rayman S, Nissan A, Sadot E. Acute appendicitis during pregnancy: different from the nonpregnant state? World J Surg. 2016;16:3731–7.
3.
go back to reference Sivit CJ, Newman KD, Boenning DA, Nussbaum-Blask AR, et al. Appendicitis: usefulness of US in diagnosis in a pediatric population. Radiology. 1992;185:549–52.CrossRefPubMed Sivit CJ, Newman KD, Boenning DA, Nussbaum-Blask AR, et al. Appendicitis: usefulness of US in diagnosis in a pediatric population. Radiology. 1992;185:549–52.CrossRefPubMed
4.
go back to reference Al-Qudah MS, Amr M, Sroujieh A, Issa A. Appendectomy in pregnancy: the experience of a university hospital. J Obstet Gynaecol. 1999;19:362–4.CrossRefPubMed Al-Qudah MS, Amr M, Sroujieh A, Issa A. Appendectomy in pregnancy: the experience of a university hospital. J Obstet Gynaecol. 1999;19:362–4.CrossRefPubMed
5.
go back to reference Yildirim E, Karagülle E, Kirbaş I, Türk E, et al. Alvarado scores and pain onset in relation to multislice CT findings in acute appendicitis. Diag Interv Radiol. 2008;14:14–8. Yildirim E, Karagülle E, Kirbaş I, Türk E, et al. Alvarado scores and pain onset in relation to multislice CT findings in acute appendicitis. Diag Interv Radiol. 2008;14:14–8.
6.
go back to reference Alvarado A. A practical score for early diagnosis of acute appendicitis. Ann Emerg Med. 1986;15:557–64.CrossRefPubMed Alvarado A. A practical score for early diagnosis of acute appendicitis. Ann Emerg Med. 1986;15:557–64.CrossRefPubMed
7.
go back to reference Horzic M, Salamon A, Koplijar M, et al. Analysis of scores in diagnosis of acute appendicitis in women. Coll Anropol. 2005;29:133–8. Horzic M, Salamon A, Koplijar M, et al. Analysis of scores in diagnosis of acute appendicitis in women. Coll Anropol. 2005;29:133–8.
8.
go back to reference Maslovitz S, Gutman G, Lessing JB, et al. The significance of clinical signs and blood indices for the diagnosis of appendicitis during pregnancy. Gynecol Obstet Investig. 2003;56:188–91.CrossRef Maslovitz S, Gutman G, Lessing JB, et al. The significance of clinical signs and blood indices for the diagnosis of appendicitis during pregnancy. Gynecol Obstet Investig. 2003;56:188–91.CrossRef
9.
go back to reference Zingone F, Sultan AA, Humes DJ, et al. Risk of acute appendicitis in and around pregnancy. Ann Surg. 2015;261:332–7.CrossRefPubMed Zingone F, Sultan AA, Humes DJ, et al. Risk of acute appendicitis in and around pregnancy. Ann Surg. 2015;261:332–7.CrossRefPubMed
10.
go back to reference Ueberrueck T, Koch A, Meyer L, Hinkel M, Gastinger I. Ninety-four Appendectomies for suspected acute appendicitis during pregnancy. World J Surg. 2004;28:508–11.CrossRefPubMed Ueberrueck T, Koch A, Meyer L, Hinkel M, Gastinger I. Ninety-four Appendectomies for suspected acute appendicitis during pregnancy. World J Surg. 2004;28:508–11.CrossRefPubMed
11.
12.
go back to reference Lim HK, Bae SH, Seo GS. Diagnosis of acute appendicitis in pregnant women: value of sonography. AJR Am J Roentgenol. 1992;159:539–42.CrossRefPubMed Lim HK, Bae SH, Seo GS. Diagnosis of acute appendicitis in pregnant women: value of sonography. AJR Am J Roentgenol. 1992;159:539–42.CrossRefPubMed
13.
go back to reference Yüksel Y, Dinç B, Yüksel D. How reliable is the Alvarado score in acute appendicitis? Ulusal Travma Acil Cerrahi Dergisi. 2014;20(1):12–8.CrossRef Yüksel Y, Dinç B, Yüksel D. How reliable is the Alvarado score in acute appendicitis? Ulusal Travma Acil Cerrahi Dergisi. 2014;20(1):12–8.CrossRef
14.
go back to reference Abou MB, Khalil M, Daoud N. Comparison of Alvarado score evaluation and clinical judgement in acute appendicitis. Med Arch. 2014;68(1):10–3.CrossRef Abou MB, Khalil M, Daoud N. Comparison of Alvarado score evaluation and clinical judgement in acute appendicitis. Med Arch. 2014;68(1):10–3.CrossRef
15.
go back to reference Tracey M, Fletcher HS. Appendicitis in pregnancy. Am Surg. 2000;66(6):555–9 (discussion 559–560).PubMed Tracey M, Fletcher HS. Appendicitis in pregnancy. Am Surg. 2000;66(6):555–9 (discussion 559–560).PubMed
16.
go back to reference Ito K, Ito H, Whang EE, Tavakkolizadeh A. Appendectomy in pregnancy: evaluation of the risks of a negative appendectomy. Am J Surg. 2012;203(2):145–50.CrossRefPubMed Ito K, Ito H, Whang EE, Tavakkolizadeh A. Appendectomy in pregnancy: evaluation of the risks of a negative appendectomy. Am J Surg. 2012;203(2):145–50.CrossRefPubMed
17.
go back to reference Aras A, Karaman E, Pekşen Ç, Kızıltan R, Kotan MÇ. The diagnosis of acute appendicitis in pregnant versus non-pregnant women: a comparative study. Rev Assoc Med Bras (1992). 2016;62(7):622–7.CrossRef Aras A, Karaman E, Pekşen Ç, Kızıltan R, Kotan MÇ. The diagnosis of acute appendicitis in pregnant versus non-pregnant women: a comparative study. Rev Assoc Med Bras (1992). 2016;62(7):622–7.CrossRef
18.
go back to reference Ozkan S, Duman A, Durukan P, Yildirim A, Ozbakan O. The accuracy rate of Alvarado score, ultrasonography, and computerized tomography scan in the diagnosis of acute appendicitis in our center. Niger J Clin Pract. 2014;17(4):413–8.CrossRefPubMed Ozkan S, Duman A, Durukan P, Yildirim A, Ozbakan O. The accuracy rate of Alvarado score, ultrasonography, and computerized tomography scan in the diagnosis of acute appendicitis in our center. Niger J Clin Pract. 2014;17(4):413–8.CrossRefPubMed
19.
go back to reference Limpawattanasiri C. Alvarado score for the acute appendicitis in a provincial hospital. J Med Assoc Thai. 2011;94(4):441–9.PubMed Limpawattanasiri C. Alvarado score for the acute appendicitis in a provincial hospital. J Med Assoc Thai. 2011;94(4):441–9.PubMed
Metadata
Title
The Alvarado Score is accurate in pregnancy: a retrospective case–control study
Authors
F. Tatli
Y. Yucel
O. Gozeneli
A. Dirican
A. Uzunkoy
H. C. Yalçın
A. Ozgonul
O. Bardakci
H. Uyanikoglu
A. İncebiyik
Publication date
01-06-2019
Publisher
Springer Berlin Heidelberg
Published in
European Journal of Trauma and Emergency Surgery / Issue 3/2019
Print ISSN: 1863-9933
Electronic ISSN: 1863-9941
DOI
https://doi.org/10.1007/s00068-017-0855-x

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