Sensibilidad y especificidad de la escala de Alvarado en pacientes con sospecha de apendicitis aguda que acudieron a la emergencia del Hospital General Guasmo Sur en el periodo del 1 de septiembre del 2021 al 1 de septiembre del 2022.

Abstract

Introduction: Acute appendicitis is the inflammation of the cecal appendix, representing the most common cause of abdominal pain and a major surgical emergency worldwide (1) Acute appendicitis is the most common abdominal surgery related to some type of trauma (2). Objective: To determine the effectiveness of the Alvarado scale in the timely diagnosis of patients with suspected acute appendicitis at the General Hospital Guasmo Sur from September 1, 2021, to September 1, 2022. Materials and methods: The population consisted of male and female patients who attended the emergency department of the General Hospital Guasmo Sur within a specific 12-month period. To conduct the study, certain inclusion criteria were used, such as male and female patients, characteristic signs and symptoms of acute appendicitis, and results of complementary tests such as complete blood count and urine analysis. Results and discussion: It was determined that the application of the Alvarado and Ripasa scales is effective for the timely diagnosis of acute appendicitis, thus avoiding complications and risks that could compromise the patient's life. In the analysis of the 227 patients, 226 patients were evaluated as 1 patient did not have an emergency department progress note and only had a hospital discharge note. Regarding the laboratory or complementary data implicit in the Alvarado scale criteria, it is worth mentioning that only 39.2% presented leukocytosis, either because the remaining percentage of patients did not report it or because the attending physician in the emergency department did not consider it appropriate to perform a complete blood count that would yield these results. This last incident is serious, as it has been observed that only 3 to 4 criteria are used for the diagnosis or exclusion of acute appendicitis based on the presence or absence of leukocytosis, which could be considered an error in diagnosis.