MODIFIED ALVARADO SCORE: A DUAL ROLE IN DIAGNOSING AND PREDICTING OUTCOMES IN ACUTE APPENDICITIS

Abstract

Objective: To evaluate the diagnostic and prognostic efficacy of the Modified Alvarado Score (MAS) in acute appendicitis, and to correlate preoperative scores with intraoperative findings and postoperative outcomes. Material and Methods: A prospective observational study was conducted at the Department of General Surgery, D.Y. Patil University School of Medicine, Navi Mumbai. One hundred consecutive patients aged ≥18 years with clinically and radiologically confirmed acute appendicitis and MAS >5 were included. Patients with acute on chronic appendicitis, pelvic inflammatory disease, adnexal pathology, or suspected tuberculosis were excluded. MAS was recorded preoperatively. Intraoperative findings, postoperative complications, and hospital stay were documented. Data were analysed using SPSS v26.0. Descriptive statistics, independent t-tests, chi-square tests, and Pearson’s correlation were applied, with p<0.05 considered significant. Results: The mean age was 27.35 ± 5.45 years; 62% were male. Intraoperatively, 77% had an inflamed appendix, 22% perforation with local peritonitis, and 1% lump formation. Mean MAS was significantly higher in perforation (8.45) compared to inflammation (6.81) (p<0.001). Patients with complications had higher MAS (7.83 vs. 6.90; p<0.001) and longer hospital stay (7.93 vs. 3.92 days; p<0.001). MAS showed a positive correlation with length of stay (r = 0.596; p<0.001). Conclusion: MAS is a simple, rapid, and inexpensive tool with high diagnostic accuracy for acute appendicitis. It also predicts intraoperative severity, postoperative complications, and hospital stay, making it valuable for clinical decision-making and patient counselling, especially in resource-limited settings.