PT  - JOURNAL ARTICLE
AU  - Patrick H Y Chung
AU  - Kanglin Dai
AU  - Zhen Yang
AU  - Kenneth K Y Wong
TI  - Validity of Alvarado Score in predicting disease severity and postoperative complication in pediatric acute appendicitis
AID  - 10.1136/wjps-2018-000003
DP  - 2019 Feb 01
TA  - World Journal of Pediatric Surgery
PG  - e000003
VI  - 2
IP  - 1
4099  - http://wjps.bmj.com/content/2/1/e000003.short
4100  - http://wjps.bmj.com/content/2/1/e000003.full
SO  - World Jnl Ped Surgery2019 Feb 01; 2
AB  - Background This study evaluates the validity of Alvarado Score in predicting disease severity and the development of postoperative complications in pediatric appendicitis.Methods This is a retrospective, bicentered study on pediatric patients with emergency appendicectomy performed from 2006 to 2016. The relationship of Alvarado Score (low: 1–4, medium: 5–6, high: 7–10) and operative findings/complications was analyzed.Results A total of 316 patients were included and the median age on admission was 10.8 years. The overall median score was 8.0. 13.3%, 20.2%, and 66.5% of patients had low, medium, and high risk scores, respectively. 36.1% of patients had complicated appendicitis and the median score was comparable with that of the uncomplicated cases (7.0 vs 7.4, p=0.21). More complicated cases were found in the medium-risk group (high vs medium vs low=29.7% vs 61.4% vs 31.0%, p=0.01). Rebound tenderness had the highest positive predictive value (65%) for complicated appendicitis. Postoperative complications were found in 16.5% of patients with a higher median score (7.87 vs 5.8, p=0.01).Conclusion Alvarado Score does not predict disease severity but postoperative complication. Patients with medium risk score should also be treated promptly for the risk of having complicated disease. Rebound tenderness may be a signal for complicated appendicitis and should be properly examined.