Evaluación de la Escala de Alvarado versus Score de respuesta inflamatoria de la apendicitis, Hospital José Carrasco Arteaga 2018

Abstract

Background: acute appendicitis is a common disease in the environment, characterized by abdominal pain, but which often occurs with atypical clinical tables that delay its surgical treatment or discard it; so, it is necessary to have an easy and useful tool that allows the timely resolution of this pathology. Objetive: assess the usefulness of the Alvarado Scale versus the Inflammatory Response of Appendicitis (AIRs) in the diagnosis of Acute Appendicitis Method and Materials: a diagnostic test validation study was conducted to compare the AIR and Alvarado scales, considering the results of pathological anatomy as a gold test. 292 patients were included at the José Carrasco Arteaga hospital during 2018. For statistical analysis, sensitivity, specificity, positive predictive value, negative predictive value, ROC curve and likelihood Ratio were obtained. Results: 49.7% of the participants are in the age group of young adults, with male predominance (62.7%), married marital status 63%, mixed ethnicity 91.4%, secondary education 58.6%. The Alvarado scale had a sensitivity of 88.5%, specificity of 29.6%, positive predictive value of 81% and negative of 42%, an LR + of 1.23 and a LR – of 0.38; that were lower than those recorded by AIR of 94.7% (sensitivity), 76.5% (specificity), positive predictive value 93%, negative predictive value of 80%, LR + 4.02 and one LR – 0.07. The area under the ROC curve of the AIRS was 0.897, higher than that of Alvarado of 0.611; conferring on the first scale greater diagnostic accuracy. Conclusion: the AIR Score has a higher specificity, positive predictive value and negative predictive value, in addition showed better diagnostic effectiveness than Alvarado's score in diagnosing acute appendicitis.