Diagnostic Efficacy of the Modified Alvarado Score for Acute Appendicitis in Pregnant Women.
- Author:
Chul Soo KIM
1
;
Hong In PARK
;
Jung Ho LEE
;
Woon Hyuk JUNG
;
Soo Hyung LEE
;
Woo Young NHO
;
Seong Hun KIM
;
Dong Wook JE
;
Michel Sung Pil CHOE
;
June Young LEE
;
Jin Kun BAE
;
Sang Mo JE
;
Tae Nyoung CHUNG
;
Eui Chung KIM
;
Sung Wook CHOI
;
Ok Jun KIM
Author Information
1. Department of Emergency Medicine, CHA Bundang Medical Center, CHA University, Seongnam, Korea.
- Publication Type:Original Article
- Keywords:
Appendicitis;
Pregnancy;
Trimester;
ROC curve
- MeSH:
Abdominal Pain;
Appendicitis*;
Appendix;
Diagnosis;
Emergency Service, Hospital;
Female;
Humans;
Magnetic Resonance Imaging;
Medical Records;
Pregnancy;
Pregnancy Trimester, First;
Pregnancy Trimester, Second;
Pregnancy Trimester, Third;
Pregnant Women*;
Retrospective Studies;
ROC Curve;
Sensitivity and Specificity;
Ultrasonography;
Uncertainty
- From:Journal of the Korean Society of Emergency Medicine
2016;27(6):586-594
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: We aimed to evaluate whether the modified Alvarado score-which is currently being used to diagnose acute appendicitis-can be applicable in the diagnosis of diseases in pregnant women. METHODS: We retrospectively analyzed the medical records of 252 pregnant women who visited our emergency department (ED) with a chief complaint of abdominal pain and a suspicion of acute appendicitis, and ultimately underwent appendix ultrasonography or appendix magnetic resonance imaging (MRI). The modified Alvarado score was calculated for each pregnant woman. A receiver operating characteristic (ROC) curve was drawn for each subject, those in the first trimester, second trimester, and third trimester, from which the best cut-off value, sensitivity and specificity were induced. RESULTS: For all 252 pregnant women who visited our ED, the area under the curve was 0.742 (p<0.001), with sensitivity and specificity of 75.41% and 62.30%, respectively, when using the value of 5 as the cut-off point for the modified Alvarado score. The area under the curve was 0.811 (p<0.001) for those in their first trimester and 0.749 (p<0.001) for those in the second trimester, while it was 0.641, with the p-value of 0.109, for those in the third trimester. CONCLUSION: There is a limitation using the modified Alvarado score alone in pregnant woman, and if there is uncertainty in the diagnosis, other imaging studies, such as appendix ultrasonography or appendix MRI, should be considered.
