The role of Alvarado and Ohmann scoring systems in diagnosing appendicitis and assessing disease severity

INTRODUCTION: Acute appendicitis is among the most common causes of acute abdomen. While diagnosis is generally straightforward, it may be challenging to differentiate from other conditions, particularly in preg-nant women and the elderly. Currently, several scoring systems have been developed to aid in diagnosis. This study aims to evaluate the significance of these scoring systems in diagnosing appendicitis and as-sessing the severity of inflammation.
METHODS: A total of 210 patients hospitalized between 01/01/2016 and 01/06/2019 at the General Surgery Clinic of the Republic of Türkiye S.B.U Van Training and Research Hospital for acute appen-dicitis were examined retrospectively. Appendectomy was performed following ultrasonography for patients evaluated using the Alvarado and Ohmann scoring systems, and these scores were compared with intra-operative severity scores. The predictive value of the Alvarado and Ohmann scoring systems in diagnosing acute appendicitis was analysed.
RESULTS: A moderate positive correlation was identified between the Alvarado and Ohmann scores (r=0.508; p<0.001). The Alvarado score demonstrated a statistically significant accuracy in predicting acute appen-dicitis diagnosis based on histopathological findings (p=0.027), whereas the Ohmann score did not show statistical significance (p=0.807). Although both scores correlated weakly with intraoperative inflamma-tion grading, a significant association was found between the Alvarado scoring system and intraoperative severity grading (r=0.30; p=0.002). No significant correlation was observed between the Ohmann score and intraoperative severity grading (r=0.09; p=0.384).
DISCUSSION AND CONCLUSION: The Alvarado scoring system proved valuable in predicting appendicitis, while the Ohmann scoring system was more useful in suggesting the exclusion of appendicitis.