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J Korean Soc Emerg Med > Volume 15(1); 2004 > Article
Journal of The Korean Society of Emergency Medicine 2004;15(1): 14-18.
Indication of an Abdominal CT Scan Using Alvarado Score in Patients Suspected Appendicitis
Yeon Ho You, Jung Soo Park, Sung Soo Park, Jung Kyu Park, Seung Whan Kim, Sung Pil Chung, In Sool Yoo
Department of Emergency Medicine, College of Medicine, Chungnam National University, Daejeon, Korea. emstar@naver.com
Although several diagnostic techniques have been introduced to evaluate appendicitis, no guidelines exists to determine which patients would benefit from these techniques. For that reason, we designed this study to use the Alvarado score to find the subgroup of patients that require CT scans.
We evaluated the medical records of patients who presented with non-traumatic right lower abdominal pain from Mar to Sep 2003. According to the initial Alvarado score, the patients were divided in a high score group and a low score group. The differences in the diagnostic accuracy were compared for each group according to the CT scan when the reference Alvarado score (AS) was changed.
Among two hundred patients, 106 underwent a CT scan. Of those 200 patients, 42 were in the high score group, and 158 were in the low score group, when the cutoff AS was 7. The diagnostic accuracy did not differ in the high score group according to the CT scan. However, a significant difference existed in the low score group and in the high score group (97% vs 80%). The difference in the diagnostic accuracy was greatest at a cutoff AS of 5.
This study suggests that a CT scan should be recommended for patients with right lower quadrant abdominal pain when the Alvarado score is less than or equal to 5.
Key words: Computed tomography, Appendicitis, Alvarado score
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