Sarcouncil Journal of Medicine and Surgery

Abstract: Background: Acute appendicitis is the commonest cause of abdominal surgical procedure with a prevalence of nearly 1 in 7 people. It is related to occasional mortality and high morbidity; this is due to the failure of diagnosing the condition earlier. Some studies demonstrate that there is no difference in the overall diagnostic accuracy of the Lintula system compared to the Alvarado system for the diagnosis of acute appendicitis. Aim of study: To compare the sensitivity, specificity and accuracy of two commonly applied scoring systems (Alvarado and Lintula) for diagnosis of acute appendicitis. Methods: A prospective study was conducted in the Department of General Surgery at Baghdad Teaching Hospital during the period of one year from 1st of July 2019 till 1st of July 2020. It included 100 patients attended the outpatient clinic or the emergency department with signs and symptoms suggestive of acute appendicitis (lower abdominal and/or right iliac fossa pain). Scoring was done to diagnose appendicitis by two scoring systems using the data for each patient, and these scoring systems were Alvarado and Lintula. The final diagnosis of pathology was done by histopathology postoperatively. Results: In this study, 82% of patients were underwent appendectomy and 47.6% of the operated cases were diagnosed as catarrhal appendicitis. Alvarado score was suggestive for acute appendicitis (positive) in 59% of study patients while Lintula score was suggestive in 64% of cases. Means of Alvarado and Lintula scores were significantly increased with severity (P= 0.001) to reach the highest level in patients diagnosed with severe appendicitis than other findings. Alvarado scoring system was 70.3% sensitive, 73.1% specific, and 71% accurate. Lintula score was 67.6% sensitive, 46.2% specific and 62% accurate. Conclusion: Lintula and Alvarado scores are comparable in the sensitivity, specificity, and accuracy for the diagnosis of acute appendicitis. Lintula score is considered simple, non-invasive way to be used.