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miércoles, 28 de diciembre de 2016

Alvarado Score

EVIDENCE BASED MEDICINE
EBM - Posted on December 26, 2016 - By mizzouem
"Originally described in 1986, the Alvarado score has been the most widely used clinical scoring system for acute appendicitis. It consists of eight predictive factors, each assigned a value of 1 or 2 based on their diagnostic weight. Score of 1 is given for: elevated temperature >37.3C, rebound tenderness, migration of pain to RLQ, anorexia, nausea or vomiting, and leukocyte left shift. Score of 2 is given for RLQ tenderness and leukocytosis >10,000...
It is currently the only clinical scoring system described in ACEP Clinical Policy guidelines (Level C recommendation). Despite its presence over the last 30 years, its diagnostic accuracy remains debatable. 
Can the Alvarado score be used effectively to rule-in or rule-out acute appendicitis?
The Bottom Line:
Low scores with a cutoff of </=3 may be appropriate for excluding appendicitis, while anything above may still need imaging to identify appropriate diagnosis. High Alvarado score with a cutoff of 7 is not predictive enough to rule-in appendicitis; however, likely warrants early surgical consultation."