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. 2016 Feb;34(2):189-92.
doi: 10.1016/j.ajem.2015.10.004. Epub 2015 Oct 22.

Predictive value of C-reactive protein, ultrasound and Alvarado score in acute appendicitis: a prospective pediatric cohort

Mohamed Zouari  1 , Mohamed Jallouli  2 , Hamdi Louati  2 , Rim Kchaou  2 , Rahma Chtourou  2 , Ahmed Kotti  2 , Mahdi Ben Dhaou  2 , Hayet Zitouni  2 , Riadh Mhiri  2
Affiliations

Predictive value of C-reactive protein, ultrasound and Alvarado score in acute appendicitis: a prospective pediatric cohort

Mohamed Zouari et al. Am J Emerg Med. 2016 Feb.

Abstract

Purpose: To evaluate whether C-reactive protein (CRP) level and ultrasound (US) results on admission could aid the diagnostic accuracy of Alvarado score.

Methods: A prospective study was performed on children <14 years admitted for suspected acute appendicitis. Patients were categorized into three groups based on the Alvarado score: group I: score 7-10, group II: score 5-6, group III: score 0-4.

Results: The difference between predictive values of Alvarado score alone and Alvarado score with CRP was not statically significant. The PPV increased from 74.29% (Alvarado score and CRP) to 93.75% (Alvarado score and US) in group 1 (P = .001) and the NPV increased from 64.86 and 79.69% (Alvarado score and CRP) to 82.6 and 88.2% (Alvarado score and US) in group 2 (P = .01) and group 3 (P = .001), respectively.

Conclusions: Alvarado score and ultrasound taken together improve the predictive value of diagnosing acute appendicitis in children.

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