Efectividad de la ultrasonografía incorporada al score Alvarado, comparada al protocolo estándar del Hospital Regional Docente de Trujillo en el diagnóstico de apendicitis aguda

Effectiveness of ultrasonography incorporated to score Alvarado, compared to standard protocol of Trujillo Regional Teaching Hospital, in the diagnostic of acute appendicitis

Abstract

Objetive: To determine whether ultrasound evaluation incorporated into the Alvarado score improves diagnostic accuracy for acute appendicitis, compared to the standard protocol used at Trujillo Regional Teaching Hospital (HRDT). Methods: We included 140 patients admitted to the emergency room because of abdominal pain and with suspected acute appendicitis during years 2009 and 2010. These were divided into 2 groups according to whether they underwent ultrasonography plus Score Alvarado (intervention group, IG) or the standard HRDT protocol (control group; CG). Results: In the IG, the sensitivity was 99.2%, the specificity was 71.4%, the positive predictive value was 98.5%, the negative predictive value was 83.3%, the positive likelihood ratio was 3.47 and the negative likelihood ratio was 0.01. In the CG, sensitivity was 93.1%, specificity was 55.6%, positive predictive value was 96.8%, negative predictive value was 35.7%, positive likelihood ratio was 2.10 and negative likelihood ratio was 0.12. Conclusion: Incorporating ultrasonography into the Score Alvarado appears to be an effective alternative for the diagnosis of appendicitis compared to the standard HRDT protocol.