Validity of the Alvarado Score in Detecting Acute Appendicitis: A Comparative Study with Histopathological Findings

Abstract Objective: To assess the reliability of the Alvarado score in diagnosing acute appendicitis, with histopathological findings serving as the reference standard. Methodology: A cross-sectional validation study was conducted in the Department of General Surgery, PAF Hospital, Islamabad (affiliated with Air University), from August 1, 2021, to March 1, 2022.After ethical approval 450 patients presenting those who experienced pain in the lower abdomen that spread to their right iliac fossa included. Patients with an Alvarado score of seven or above were thought to have a very high likelihood of having acute appendicitis. Histopathological findings were taken as the definitive diagnosis. We employed the Chi-square test, which considers a p-value less than 0.05 to be statistically significant, for categorical variables. Results: The mean age of the patients was 30.57 ± 5.58 years, with a mean weight of 76.61 ± 5.24 kg and a mean symptom duration of 2.42 ± 1.25 days. The Alvarado score identified 152 (33.8%) patients with acute appendicitis, while histopathology confirmed 122 (27.1%) cases. Overall diagnostic accuracy was 88%, with sensitivity at 89.3%, specificity at 86.9%, PPV at 71.7%, and NPV at 95.6%, according to the Alvarado score. Conclusion: The Alvarado score is a reliable clinical tool for diagnosing acute appendicitis, particularly at both extremes of the scoring range. Key Words: Acute Appendicitis, Alvarado Score, Diagnostic Accuracy, Histopathology, Sensitivity, Predictive Value, Specificity.