Tzanaki Score Vs Modified Alvarado Score in Predicting Acute Appendicitis

Introduction: Acute appendicitis is one of the most common causes of acuteabdomen presenting to emergency. Despite many diagnostic modalities, thereis always a clinical dilemma in diagnosing acute appendicitis. Many scoringsystems were established to help in diagnosing acute appendicitis (AA) andreduce unnecessary surgeries. The aim of this study was to compare Tzanakiscore with Modified Alvarado Score in predicting acute appendicitis. Methods: This prospective observational study was conducted in theDepartment of General Surgery, Bir Hospital, NAMS, Kathmandu, Nepal, over 12months (August 2021–June 2022) to compare the diagnostic accuracy of theModified Alvarado Score and Tzanakis Score in predicting acute appendicitis. Atotal of 73 patients presenting with clinical features of acute appendicitis wereenrolled, excluding those younger than 16 years, managed conservatively, orpresenting with appendicular lump, abscess, or generalized peritonitis. Detailedclinical, laboratory, and imaging findings were recorded, and both scoringsystems were applied. Patients diagnosed with appendicitis underwent surgery,with histopathological examination confirming the diagnosis. Results: 75% patients had Positive MAS (MAS score ≥7), of which, all patients hadpostitive HPE. Of the remaining 18 patients with MAS <7, 14 patients had positiveHPE and 4 had negative HPE. This resulted in a sensitivity of 79.71%, specificity of100%, PPV of 100% and NPV of 98%. Of 93% patients with positive Tzanakis score(≥8) 68 had positive HPE. Those with negative Tzanki score (<8), HPE was positivein 1 patient and negative in 4 patients. Sensitivity, specificity, PPV, NPV and inour study was 98%, 75%, 100% and 99% respectively. Conclusion: Tzanakis scoring and MAS scoring both can be used for diagnosingacute appendicitis and reducing the rate of negative appendectomy.However, Tzankis scoring system is better in predicting Acute Appendicitis in ourpopulation than Modified Alvarado Scoring system