A comparative study of Appendicitis inflammatory response (AIR) score with Alvarado score in diagnosis of acute appendicitis at KCMC Hospital

Kishe AS 2, *, Chilonga KS 1, 2, Msuya D 1, 2, Herman A 1, 2, Mboya M 3, Shilanaiman HN 2, Babu H 2 and Chugulu S 2

1 Department of General Surgery, Kilimanjaro Christian Medical Centre, P.O Box 3010 Moshi, Tanzania.
2 Department of General Surgery, Kilimanjaro Christian Medical University College, P.0 Box 2240 Moshi, Tanzania.
3 Department of Epidemiology and Biostatics, Institute of Public Health, Kilimanjaro Christian Medical University College, Moshi, Tanzania.
 
Research Article
World Journal of Biology Pharmacy and Health Sciences, 2024, 19(02), 017–026.
Article DOI: 10.30574/wjbphs.2024.19.2.0479
Publication history: 
Received on 21 June 2024; revised on 28 July 2024; accepted on 31 July 2024
 
Abstract: 
Background: Acute appendicitis is an acute inflammation of the appendix, most resulted from obstruction of the lumen of the appendix. It is one of the most common causes of acute abdomen. Although a very common and long-known phenomenon, appendicitis remains a diagnostic challenge for most surgeons.
Objective: To compare the validity of Appendicitis Inflammatory Response Score with Alvarado score in diagnosis of acute appendicitis at KCMC Hospital.
Methods: A prospective hospital based cross sectional study done over a period of six months (September 2016 to March 2017). Patients were admitted to general surgical ward after the diagnosis of acute appendicitis reached and all parameters included in the AIR score and Alvarado score were prospectively recorded on patients presenting symptoms of acute appendicitis. All removed appendix specimens were sent for histopathological examination. Data was entered and analyzed using statistical package of social sciences version 20.
Results: A total of 35 patients enrolled in this study, 57% male, male to female ratio 1.3:1, mean age of 27(14-49) years. 31 patients confirmed histologicaly to have features of acute appendicitis, among these inflamed appendicitis were 51.6%. And advanced appendicitis 48.4% and negative appendicectomy rate was 11.4%. The sensitivity and specificity of both AIR and Alvarado score were 54.4%, 77.4% and 75%, 75%. PPV and NPV were 94.4%, 96% and 17.6%, 30% respectively.
Conclusion: From our study we have seen Alvarado score is a better assessment tool that is accurate helping in diagnosis of acute appendicitis. Its high sensitivity and ROC is greater than that of the AIR score. We conclude that AS has outperform AIR score in accuracy in diagnosis of AA.
 
Keywords: 
Acute appendicitis; Alvarado score; AIR score; Sensitivity and specificity
 
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