UMEM Educational Pearls

Title: Appendicitis: What is the score?

Category: Gastrointestional

Keywords: Appendicitis, scoring, prediction, Alvarado Score (PubMed Search)

Posted: 4/6/2025 by Robert Flint, MD (Updated: 4/13/2025)
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Missed appendicitis leading to rupture and peritonitis leads to morbidity, mortality, and malpractice claims. Part of a longer article looking at evaluation and management of appendicitis, these authors provide three scoring systems that can be used to identify appendicitis. Use of these scores can guide imaging and surgical consultation. 

 

Alvarado Score: If a patient scores 1 to 4, the risk of appendicitis drops to 33%. If a patient scores >5, the risk of acute appendicitis is 66% or greater.

References

Evidence-based, cost-effective management of acute appendicitis: An algorithm of the Journal of Trauma and Acute Care Surgery emergency general surgery algorithms work group

Diaz, Jose J. MD, CPE, CNS, FACS, FCCM; Napolitano, Lena MD; Livingston, David H. MD; Costantini, Todd MD; Inaba, Kenji MD; Biffl, Walter L. MD; Winchell, Robert MD; Salim, Ali MD; Coimbra, Raul MD, PhD

Author Information

Journal of Trauma and Acute Care Surgery 98(3):p 368-373, March 2025. | DOI: 10.1097/TA.0000000000004569