Score of Alvarado and data anatomo-pathological for the diagnosis of acute appendicitis Preliminary study in three hospitals of Kinshasa

Abstract

Context and objective.  The Alvarado score (AS) helps the diagnosis of acute appendicitis (AA) in the absence of injected abdominal CT scan. The present study aimed to compare the performance of AS to pathological findings in the diagnosis of AA. Methods. This was an analytical case series of patients with AA admitted in 3 hospitals in Kinshasa between January and June 2023. The AS, the aspect of the appendix in intraoperative, and the anatomopathological results (APR) were the parameters of interest. The student’s t and Pearson's Chi-square tests were used to calculate means and proportions, logistic regression to determine associations, and the ROC curve for AS performance. Results. Of 113 patients included, 77.9% were women, aged between 11 and 71 years, with a median age of 20 years and a male/female sex ratio of 1/3. In intraoperative, the midsize of the appendix was 9.47 ± 1.6 cm, with a catarrhal appearance in 78.6%. The APR concluded that ulcero-suppurative appendicitis was present in 78.8% compared to 3.5% with a normal appendix. In 52.2% of patients, the AS was 5-6, with a sensitivity of 98% to the ROC curve. Conclusion. Most patients are women with right pelvis pain alone or associated with another digestive complaint. The AS is proving to be an aid in the diagnosis of AA in the absence of the injected abdominal CT scan gold standard. Its positive correlation with APR supports its widespread use in resource-limited settings, to reduce the rate of unnecessary appendectomies.

Received: October 4^th, 2024

Accepted: January 11^th, 2025

https://dx.doi.org/10.4314/aamed.v18i2.12