The Alvarado Score vs Ohmann Score for the Diagnosis of Acute Appendicitis, Calibration with Operative and Histopathological Confirmations

Introduction Alvarado score and Ohmann Score has been used traditionally in preoperative diagnosis of acute appendicitis. The validity of the score in certain patients groups and at different cut points is still debatable. This study is aimed to assess the calibration performance of Alvarado scores and Ohmann scores with the operative and histopathological reports. Methods We assessed the accuracy of the score at cut of point 6 and 12.5 respectively from the above said scores respectively. Calibration was compared with operative findings and histopathological reports. Results A total 198 patients (male greater than18= 128 maleless than 18= 12 female greater than18= 49 female less than18= 9) after initial assessment with the Alvarado score and Ohmann Score were included in this study. Of the above 187 patients underwent appendectomy, 01 patient underwent drainage of localized collection and 07 patients where managed conservatively after confirmation of lump. In 3 three cases the surgery but was abandoned due to dense adherent lump intraoperatively. Further there operative findings and histopathological confirmations were calibrated with above scoring systems. Group 1-presented within 24hrs since onset of symptoms- ( 131/ 198 patients-66 %). Group 2 Who presented history greater than 24hrs since onset of symptoms- ( 67 patients/33 %). Group 1 Alvarado score ranged upto 6 predicted – 66 % for aute appendicitis. And Ohmann Score ranged upto 12.5 predicted -38 % for acute appendicitis. But operative and histopathological confirmations of this score were consistent with 120/131=91.6 % towards acute appendicitis and around 8.4 % suggestive of normal or other causes in females and childrens. Group 2 Alvarado score ranged— upto 10 predicted for acute appendicitis-93 % And Ohmann Score greater than 13.5-predicted for acute appendicitis-74 %. But operative and histopathological confirmations of this score were consistent with complicated appendicitis. Operative time was average 30 min vs 120 min and Postoperat