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    • Calcs that help predict probability of a diseaseDiagnosis
    • Subcategory of 'Diagnosis' designed to be very sensitiveRule Out
    • Disease is diagnosed: prognosticate to guide treatmentPrognosis
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    Attention COACH STUDY participants:

    The principal investigators of the study request that you use the official version of the modified score here.

    Alvarado Score for Acute Appendicitis

    Predicts likelihood of appendicitis diagnosis.
    When to Use
    Pearls/Pitfalls
    Why Use

    Patients with suspected acute appendicitis (typically with right lower quadrant pain).

    • More accurate at extremes than for equivocal scores, so it is unclear whether Alvarado scoring is better than gestalt.

    • Symptoms may overlap with other diseases; i.e., higher scores are found in patients with non-appendiceal inflammatory conditions, such as diverticulitis or acute pelvic inflammatory disease. It is important to consider the whole clinical picture in making the diagnosis of appendicitis.

    • Note that several modifications of the score exist, which may be appropriate in specific settings such as pregnant patients, children, and low-resource settings (without lab availability), but the original Alvarado Score remains the best studied and validated in a general population.

    Acute appendicitis is the most common surgical emergency in the US. Diagnostic accuracy is increased with greater usage of CT scanning; however, CT confers risks and disadvantages such as cost, radiation exposure, and contrast-related complications. The Alvarado Score is a well-established and widely-used clinical decision tool that may help reduce CT usage.

    Signs
    No
    0
    Yes
    +2
    No
    0
    Yes
    +1
    No
    0
    Yes
    +1
    Symptoms
    No
    0
    Yes
    +1
    No
    0
    Yes
    +1
    No
    0
    Yes
    +1
    Laboratory Values
    No
    0
    Yes
    +2
    No
    0
    Yes
    +1

    Result:

    Please fill out required fields.

    Next Steps
    Evidence
    Creator Insights
    Dr. Alfredo Alvarado

    About the Creator

    Alfredo Alvarado, MD, is a retired general surgeon, formerly at Plantation General Hospital in Florida. He previously held staff positions at Florida Medical Center and Westside Regional Hospital. Dr. Alvarado completed medical training at the National University of Colombia and residencies in general and thoracic surgery.

    To view Dr. Alfredo Alvarado's publications, visit PubMed

    Are you Dr. Alfredo Alvarado? Send us a message to review your photo and bio, and find out how to submit Creator Insights!
    MDCalc loves calculator creators – researchers who, through intelligent and often complex methods, discover tools that describe scientific facts that can then be applied in practice. These are real scientific discoveries about the nature of the human body, which can be invaluable to physicians taking care of patients.
    Content Contributors
    • Ayomide Loye, MD
    • Xiao Chi Zhang, MD, MS
    About the Creator
    Dr. Alfredo Alvarado
    Are you Dr. Alfredo Alvarado?
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