2021, Number 6
Outcomes of the application of Alvarado score in a municipal hospital
Language: Spanish
References: 30
Page: 860-872
PDF size: 549.54 Kb.
ABSTRACT
Background: acute appendicitis is one of the most common diagnoses among patients with acute abdomen. Diagnosis can be improved by using clinical scoring systems.Objective: to describe the results obtained with the Alvarado score for the diagnosis of acute appendicitis in a municipal hospital.
Methods: a descriptive, cross-sectional and retrospective study was carried out at the Manuel Piti Fajardo Hospital in Florida municipality, Camagüey province, from January to December 2020. The universe consisted of all patients operated on with acute appendicitis diagnosis, excluding those with different diagnosis and appendiceal mass. Independent variables were sex, age, time of evolution of the disease, clinical data at admission, auxiliary studies and their results. Alvarado score was the dependent variable. The medical records and a prepared spread sheet were used as a source to empty the data.
Results: 43 patients were treated whit acute appendicitis; the age group more affected was that of 20 to 40 years old, male sex was predominant. Mostly the patients had less than 24 hours of the disease. Tenderness and rebound pain in the right lower quadrant were the mains clinical data. White blood cell count was the more frequent study. The majority of the patients had a high risk score in Alvarado scoring system.
Conclusions: high risk score in Alvarado scoring system was predominant, age between 20 and 40 years old, male gender and positive results in auxiliary studies were related whit a higher score.
REFERENCES
Cervellin G, Mora R, Ticinesi A, Comelli I, Catena F, Lippi G. Epidemiology and outcomes of acute abdominal pain in a large urban Emergency Department: retrospective analysis of 5,340 cases. Annals of Translational Medicine [Internet]. 2016 [citado 13 Ene 2021];4(19):[aprox. 8 p.]. Disponible en: Disponible en: http://dx.doi.org/10.21037/atm.2016.09.10
Di Saverio S, Podda M, De Simone B, Ceresoli M, Austin G, Gori A, et al. Diagnosis and treatment of acute appendicitis: 2020 update of the WSES Jerusalem guidelines. World Journal of Emergency Surgery [Internet]. 2020 [citado 13 Ene 2021];15(27):[aprox. 42 p.]. Disponible en: Disponible en: https://doi.org/10.1186/s13017-020-00306-3
Gomes CA, Abu-Zidan FM, Sarteli M,Coccolini F, Ansaloni L, BaiocchiGL, et al. Management of appendicitis globally based on income of countries (MAGIC) study. World Journal of Surgery [Internet]. 2018 [citado 14 Ene 2021];42(12):[aprox. 8 p.]. Disponible en: Disponible en: https://doi.org/10.1007/s00268-018-4736-1
Haijanen J, Sippola S, Tuominen R, Gronroos J, Paajanen H, Rautio T, et al. Cost analysis of antibiotic therapy versus appendectomy for treatment of uncomplicated appendicitis: 5 year results of the APPAC randomized clinical trial. PLoSONE [Internet]. 2019 [citado 14 Ene 2021];14(7):[aprox 12 p.]. Disponible en: Disponible en: https://doi.org/10.1371/journal.pone.0220202
Gregory S, Kuntz K, Sainford F, Kharbanda A. Cost-effectiveness of integrating a clinical decision rule and staged imaging protocol for diagnosis of appendicitis. Value in Health [Internet]. 2016 [citado 14 Ene 2021];19(1):[aprox 7 p.]. Disponible en: Disponible en: https://pubmed.ncbi.nlm.nih.gov/26797233/ .
Sippola S, Virtanen J, Tammilehto V, Gronroos J, Hurme S, Niiniviita H, et al. The accuracy of low-dose computed tpmography protocol in patients with suspected acute appendicitis: the OPTICAP study. Ann Surg [Internet]. 2020 [citado 15 Ene 2021];271(2):[aprox. 6 p.]. Disponible en: Disponible en: https://pubmed.ncbi.nlm.nih.gov/30048324
Podda M, Gerardi C, Pharm D, Cillara N, Fearnhead N, Gomes CA, et al. Antibiotic treatment and appendectomy for uncomplicated acute appendicitis in adults and children: a systematic review and meta-analysis. Ann Surg [Internet]. 2019 [citado 20 Ene 2021];270(6):[aprox 20 p.]. Disponible en: Disponible en: https://pubmed.ncbi.nlm.nih.gov/30720508/ .
Andersson M, Kolodziej B, Andersson RE; STRAPPSCORE study group. Randomized clinical trial of Appendicitis Inflammatory Response score-based management of patients with suspected appendicitis: Appendicitis Inflammatory Response scorebased management of suspected appendicitis. Br J Surg [Internet]. 2017 [citado 2 Feb 2021];104(11):[aprox. 10 p.]. Disponible en: Disponible en: https://doi:10.1002/bjs.10637
Coleman JJ, Carr BW, Rogers T, Field MS, Zarzaur BL, Savage SA, et al. The Alvarado score should be used to reduce emergency department length of stay and radiation exposure in select patients with abdominal pain. J Traum Acute Care Surg [Internet]. 2018 [citado 02 Feb 2021];84(6):[aprox. 4 p.]. Disponible en: Disponible en: https://doi:10.1097/TA.0000000000001885.PMID:29521805
López Abreu Y, Fernández Gómez A, Hernández Paneque Y, Pérez Suarez MJ. Evaluación de la escala de Alvarado en el diagnóstico clínico de la apendicitis aguda. Rev habanera cienc méd [Internet]. 2016 [citado 02 Feb 2021];15(2):[aprox. 9 p.]. Disponible en: Disponible en: https://www.revhabanera.sld.cu/index.php/rhab/article/view/1146/991
Díaz Barrientos CZ, Aquino González A, Heredia Montaño M, Navarro Tovar F, Pineda Espinosa MA, Espinosa de Santillana IA. Escala RIPASA para el diagnóstico de apendicitis aguda: comparación con la escala de Alvarado modificada. Rev Gastroenterología de México [Internet]. 2018 [citado 02 Feb 2021];83(2):[aprox. 4 p.]. Disponible en: Disponible en: http://www.revistagastroenterologiamexico.org/es-escala-ripasa-el-diagnostico-apendicitis-articulo-S0375090618300272
Peralta Rodríguez KV, Caballero Rodríguez CA, Mora Vázquez MP. Validez diagnóstica de la escala de Alvarado en pacientes con dolor abdominal sugestivo de apendicitis, en un hospital de tercer nivel, del sur de Bogotá. Rev UDCA Act&Div Cient [Internet]. 2017 [citado 02 Feb 2021];20(1):[aprox. 7 p.]. Disponible en: Disponible en: http://www.scielo.org.co/pdf/rudca/v20n1/v20n1a02.pdf
Casado Méndez PR, Santos Fonseca RS, Méndez Lopez HA, Méndez Jiménez O, Pérez Villavicencio AM, Moreno Núñez R. Valor actual de la secuencia de Murphy en el diagnóstico de apendicitis aguda. Arch med Camagüey [Internet]. 2017 [citado 21 Ene 2021];21(1):[aprox 12 p.]. Disponible en: Disponible en: https://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S1025-02552017000100006
Pereira Lima A, José Vieira F, de Moraes Oliveira GP, Dos Santos Ramos P, Elisa Avelino M, García Prado F, et al. Clinical-epidemiological profile of acute appendicitis: retrospective analysis of 638 cases. Rev Col Bras Cir [Internet]. 2016 [citado 20 Ene 2021];43(4):[aprox. 5 p.]. Disponible en: Disponible en: https://doi.org/10.1590/s0100-69912016004009
Zbierska K, Kenig J, Lasek A, Rubinkiewicz M, Walega P. Differences in the clinical course of acute appendicitis in the elderly in comparison to younger population. Polski Przeglad Chirurgiczny [Internet]. 2016 [citado 21 Ene 2021];88(3):[aprox. 5 p.]. Disponible en: Disponible en: https://doi.org/10.1515/pjs.2016-0042
Köse E, Hasbahçeci M, Aydın MC, Toy C, Saydam T, Özsoy A, et al. Is it beneficial to use clinical scoring systems for acute appendicitis in adults? Ulus Travma Acil Cerrahi Derg [Internet]. 2019 [citado 20 Ene 2021];25(1):[aprox. 8 p.]. Disponible en: Disponible en: https://jag.journalagent.com/z4/download_fulltext.asp?pdir=travma&plng=eng&un=UTD-22378
Tekeli MT, Ilhan E, Ureyen O, Senlikci A, Yeldan E, Ozturk M, et al. How much reliable is Alvarado scoring system in reducing negative appendectomy. Indian J Surg [Internet]. 2017 [citado 05 Feb 2021];79(2):[aprox. 6 p.]. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5386934/#!po=70.0000
Quezada Suárez L, Ival Pelayo M, González Meriño CL. La escala de Alvarado como recurso clínico para el diagnóstico de apendicitis aguda. Rev Cubana de Cirugía [Internet]. 2015 [citado 21 Ene 2021];54(2):[aprox. 8 p.] Disponible en: Disponible en: https://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S0034-74932015000200004
Sartelli M, Baiocchi GL, Di Saverio S, Francesco F, Labricciosa FM, Ansaloni L, et al. Prospective observational study on acute appendicitis worldwide (POSAW). World Journal of Emergency Surgery [Internet]. 2018 [citado 20 Ene 2021];13(19):[aprox 10 p.]. Disponible en: Disponible en: https://doi.org/10.1186/s13017-018-0179-0
Martínez Rodríguez JA, Ramírez Guirado A, Albertini López G, Gómez Arocha K, Rubio González D. Escala RIPASA para el diagnóstico de apendicitis aguda en el Hospital General Freire de Andrade. Rev Cub de Cirugía [Internet]. 2020 [citado 20 Ene 2021];59(1):[aprox. 16 p.]. Disponible en: Disponible en: https://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S0034-74932020000100005