Aim: To find out
how accurate the Alvarado and Tzanaki scoring systems are in diagnosing acute
appendicitis taking histopathology as gold standard.
cross-sectional prospective study was conducted from August 2019 to July 2020
at Department of General Surgery, Pakistan Institute of Medical Sciences
Islamabad. Sixty patients were included, all of whom had appendectomies after a
clinical diagnosis of acute appendicitis. Samples were submitted for
histopathology, which was used as the gold standard for the definitive
diagnosis of acute appendicitis. The specificity, sensitivity, positive
predictive value (PPV), negative predictive value (NPV), diagnostic accuracy
and negative appendectomy rate of Alvarado and Tzanaki scoring systems was
calculated using SPSS version 23.
sensitivity, specificity, positive predictive value, negative predictive value
and diagnostic accuracy of Alvarado score at optimal cut-off threshold of ≥7.0,
were calculated as 74%, 55%, 90%, 27% and 71.66% respectively. The cut-off
threshold point of Tzanaki score was set at more than 8, which yielded a 94.11%
sensitivity and an 88.88% specificity. The positive predictive value was 99.95%
and the negative predictive value was 72.72%. The Alvarado and Tzanaki scoring
systems had negative appendectomy rates of 9.5% and 2.04%, respectively.
Conclusion: The Tzanaki scoring system has a better diagnostic accuracy for acute
appendicitis as compared to the Alvarado score.
appendicitis, Alvarado score, Tzanaki score