| 词条 | Alvarado score | ||||||||||||||||||||||||
| 释义 |
| name = Alvarado score | image = | alt = | caption = | pronounce = | synonyms = | purpose = Diagnosis of appendicitis | reference_range = | calculator = | DiseasesDB = | ICD10 = | ICD9 = | ICDO = | MedlinePlus = | eMedicine = | MeshID = | OPS301 = | LOINC = }} The Alvarado score is a clinical scoring system used in the diagnosis of appendicitis.[1] The score has 6 clinical items and 2 laboratory measurements with a total 10 points. It was introduced in 1986 and although meant for pregnant females, it has been extensively validated in the non-pregnant population. The modified Alvarado score is at present in use.[2] The Alvarado score has largely been superseded as a clinical prediction tool by the Appendicitis Inflammatory Response score [3][4][5]. The score
Elements from the person's history, the physical examination and from laboratory tests:
The two most important factors, tenderness in the right lower quadrant and leukocytosis, are assigned two points, and the six other factors are assigned one point each, for a possible total score of ten points. A score of 5 or 6 is compatible with the diagnosis of acute appendicitis. A score of 7 or 8 indicates a probable appendicitis, and a score of 9 or 10 indicates a very probable acute appendicitis.[6] Complementary valueThe original Alvarado score describes a possible total of 10 points, but those medical facilities that are unable to perform a differential white blood cell count, are using a Modified Alvarado Score with a total of 9 points which could be not as accurate as the original score. The high diagnostic value of the score has been confirmed in a number of studies across the world. The consensus is that the Alvarado score is a noninvasive, safe, diagnostic method, which is simple, reliable and repeatable, and able to guide the clinician in the management of the case. However, a recent study demonstrated a sensitivity of only 72% of the Alvarado Score for detection of appendicitis which has led to criticism of the usefulness of the score. Scores of less than five in children were useful for eliminating appendicitis from the differential diagnosis.[7] SignificanceIt carries high significance in the diagnosis of acute appendicitis.[8][9][10][11][12][13] References1. ^{{cite journal|last1=Alvarado|first1=A|title=A practical score for the early diagnosis of acute appendicitis.|journal=Annals of Emergency Medicine|date=May 1986|volume=15|issue=5|pages=557–64|doi=10.1016/S0196-0644(86)80993-3|pmid=3963537}} 2. ^{{cite book|last=Augustin|first=Goran|title=Acute Abdomen During Pregnancy|url=https://books.google.com/books?id=mq8pBAAAQBAJ&pg=PA8|date=12 May 2014|publisher=Springer|isbn=978-3-319-05422-3|pages=8}} 3. ^{{Cite journal|last=Andersson|first=Manne|last2=Andersson|first2=Roland E.|date=August 2008|title=The appendicitis inflammatory response score: a tool for the diagnosis of acute appendicitis that outperforms the Alvarado score|journal=World Journal of Surgery|volume=32|issue=8|pages=1843–1849|doi=10.1007/s00268-008-9649-y|issn=0364-2313|pmid=18553045}} 4. ^{{Cite journal|last=de Castro|first=S. M. M.|last2=Ünlü|first2=Ç.|last3=Steller|first3=E. Ph.|last4=van Wagensveld|first4=B. A.|last5=Vrouenraets|first5=B. C.|date=July 2012|title=Evaluation of the Appendicitis Inflammatory Response Score for Patients with Acute Appendicitis|journal=World Journal of Surgery|volume=36|issue=7|pages=1540–1545|doi=10.1007/s00268-012-1521-4|issn=0364-2313|pmc=3368113|pmid=22447205}} 5. ^{{Cite journal|last=Kollár|first=D.|last2=McCartan|first2=D. P.|last3=Bourke|first3=M.|last4=Cross|first4=K. S.|last5=Dowdall|first5=J.|date=2014-09-23|title=Predicting Acute Appendicitis? A comparison of the Alvarado Score, the Appendicitis Inflammatory Response Score and Clinical Assessment|journal=World Journal of Surgery|language=en|volume=39|issue=1|pages=104–109|doi=10.1007/s00268-014-2794-6|pmid=25245432|issn=0364-2313}} 6. ^{{cite journal|last1=Douglas|first1=CD|title=Randomised controlled trial of ultrasonography in diagnosis of acute appendicitis, incorporating the Alvarado score|journal=BMJ|date=14 October 2000|volume=321|issue=7266|pages=919–22|doi=10.1136/bmj.321.7266.919|pmid=11030676|pmc=27498}} 7. ^{{cite journal |vauthors=Bundy DG, Byerley JS, Liles EA, Perrin EM, Katznelson J, Rice HE |author-link2=Julie Story Byerley|title=Does this child have appendicitis? |journal=JAMA |volume=298 |issue=4 |pages=438–51 |year=2007 |pmid=17652298 |pmc=2703737 |doi=10.1001/jama.298.4.438 }} 8. ^{{cite journal|last1=Crnogorac|first1=S|last2=Lovrenski|first2=J|title=[Validation of the Alvarado score in the diagnosis of acute appendicitis].|journal=Medicinski Pregled|date=2000|volume=54|issue=11–12|pages=557–61|pmid=11921691}} 9. ^{{cite journal|last1=Chan|first1=MY|last2=Teo|first2=BS|last3=Ng|first3=BL|title=The Alvarado score and acute appendicitis.|journal=Annals of the Academy of Medicine, Singapore|date=September 2001|volume=30|issue=5|pages=510–2|pmid=11603135}} 10. ^{{cite journal|last1=Kalan|first1=M|last2=Talbot|first2=D|last3=Cunliffe|first3=WJ|last4=Rich|first4=AJ|title=Evaluation of the modified Alvarado score in the diagnosis of acute appendicitis: a prospective study.|journal=Ann R Coll Surg Engl|date=Nov 1994|volume=76|issue=6|pages=418–419|pmc=2502264|pmid=7702329}} 11. ^{{cite journal|last1=Macklin|first1=CP|last2=Radcliffe|first2=GS|last3=Merei|first3=JM|last4=Stringer|first4=MD|title=A prospective evaluation of the modified Alvarado score for acute appendicitis in children.|journal=Annals of the Royal College of Surgeons of England|date=May 1997|volume=79|issue=3|pages=203–5|pmid=9196342|pmc=2502889}} 12. ^{{cite journal|last1=Meltzer|first1=Andrew C.|last2=Baumann|first2=Brigitte M.|last3=Chen|first3=Esther H.|last4=Shofer|first4=Frances S.|last5=Mills|first5=Angela M.|title=Poor Sensitivity of a Modified Alvarado Score in Adults With Suspected Appendicitis|journal=Annals of Emergency Medicine|date=August 2013|volume=62|issue=2|pages=126–131|doi=10.1016/j.annemergmed.2013.01.021|pmid=23623557}} 13. ^{{cite journal|last1=Al Qahtani|first1=HH|last2=Muhammad|first2=AA|title=Alvarado score as an admission criterion for suspected appendicitis in adults.|journal=Saudi Journal of Gastroenterology|date=May 2004|volume=10|issue=2|pages=86–91|pmid=19861831}}
External links[https://www.evidencio.com/models/show/159 Online calculator of the Alvarado Score] 3 : General surgery|Gastroenterology|Medical scoring system |
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