The use of the Alvarado score in the management of right lower quadrant abdominal pain in the adult
| Autor: | A. Guesdon-Portes, Antoine Hamy, Emilie Eyssartier, Jean-Pierre Arnaud, Paul Lada, Stéphanie Mucci, Christine Casa, Y. Pouget-Baudry |
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| Přispěvatelé: | Centre Hospitalier Universitaire d'Angers (CHU Angers), PRES Université Nantes Angers Le Mans (UNAM), Hémodynamique, Interaction Fibrose et Invasivité tumorales Hépatiques (HIFIH), Université d'Angers (UA) |
| Rok vydání: | 2010 |
| Předmět: |
Male
Abdominal pain Erythrocytes [SDV]Life Sciences [q-bio] Radiography 0302 clinical medicine Abdomen 80 and over Leukocytes Prospective Studies Prospective cohort study Pain Measurement Ultrasonography Aged 80 and over Emergency Service medicine.diagnostic_test General Medicine Middle Aged Appendix 3. Good health medicine.anatomical_structure C-Reactive Protein Alvarado score 030220 oncology & carcinogenesis Female Radiology medicine.symptom Emergency Service Hospital Adult Radiography Abdominal medicine.medical_specialty Urinalysis Adolescent Decision Making Hospital 03 medical and health sciences Young Adult medicine Humans Abdominal Aged business.industry Reproducibility of Results 030208 emergency & critical care medicine medicine.disease Appendicitis Surgery Abdominal Pain business |
| Zdroj: | Journal of Visceral Surgery Journal of Visceral Surgery, Elsevier, 2010, 147 (2), pp.e40-e44. ⟨10.1016/j.jviscsurg.2010.05.002⟩ |
| ISSN: | 1878-7886 |
| Popis: | International audience; AIM OF THE STUDY: The Alvarado score is a validated test in clinical adult surgery practice which can be helpful in the diagnosis of acute appendicitis. This study aimed to assess the reliability and the reproducibility of this score for patients presenting in the emergency room with acute right lower quadrant abdominal pain.MATERIAL AND METHODS: A prospective monocenter study included all adults who presented in the emergency room with right lower quadrant abdominal pain. The score was calculated by assessing six symptoms and two laboratory values weighted by coefficients. The diagnosis of acute appendicitis was confirmed by the histological examination of the resected appendix. Three groups of patients with high, low, and intermediate scores were defined as described in the literature.RESULTS: Of the 233 patients studied, 174 underwent surgery: three had a normal appendix on histological exam. The statistical analysis of the results showed that a score lower than 4 was significantly associated with the absence of acute appendicitis while a score higher than 6 was significantly associated with acute appendicitis which required surgical care. But a score between 4 and 6 was not discriminant.CONCLUSION: The Alvarado score is a reliable, cheap and reproducible tool for the diagnosis of acute appendicitis in the emergency room; if the score is higher than 6 or lower than 4, there is no need for complementary exams. Patients with a score between 4 and 6, require serial reassessment of physical findings and score over 24 hours and/or complementary diagnostic exam such as ultrasound or CT scan. |
| Databáze: | OpenAIRE |
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