Researchgate

Researchgate

Appendix Scores for use with children

Scoring systems for appendicitis

The Alvarado score and the Pediatric Appendicitis Score (PAS) are the most widely used scoring systems for diagnosing appendicitis in children. Both scores take into account the child's symptoms, physical examination findings, and laboratory test results.

Alvarado Score

The Alvarado score was developed in 1986 by Dr. Andrew Alvarado. It is a 10-point scale that assigns points for the following factors:

• Nausea
• Vomiting
• Right lower quadrant pain
• Rebound tenderness
• Fever
• Leukocytosis
• Neutrophilia

A score of 7 or higher is considered to be indicative of appendicitis.

Pediatric Appendicitis Score (PAS)

The PAS was developed in 1994 by Dr. George Holzman. It is a 10-point scale that assigns points for the following factors:

• Age
• Duration of symptoms
• Right lower quadrant pain
• Rebound tenderness
• Rovsing's sign
• Psoas sign
• Obturator sign
• Leukocytosis
• Neutrophilia

A score of 4 or higher is considered to be indicative of appendicitis.

Comparison of Alvarado and PAS Scores

In a meta-analysis of 26 studies involving 5985 children in 11 countries, the Alvarado Score had a sensitivity of 86% and a specificity of 82% for diagnosing appendicitis. The PAS had a sensitivity of 85% and a specificity of 80%.

Both the Alvarado Score and the PAS are useful for diagnosing appendicitis in children. However, the Alvarado Score is slightly more sensitive than the PAS, while the PAS is slightly more specific. The choice of which score to use depends on the individual clinician's preference.