The Alvarado score application in diagnosing suspected acute appendicitis

Introduction: Appendicitis is an inflammation of the appendix, clinically presenting with abdominal pain most commonly located in the right lower quadrant, with possible pain migration or initial periumbilical pain, accompanied by fever, loss of appetite, nausea, and vomiting. Because of the nonspecific nature of these symptoms, various scoring systems have been developed to facilitate the process of establishing a working diagnosis in the cases of suspected acute appendicitis. The most commonly used scoring systems are the Alvarado Score and the AIR (Appendicitis Inflammatory Response) Score. Objective: To assess the significance of applying the Alvarado Score in cases ofsuspected acute appendicitis in prehospital settings.Case report: The Emergency Medical Service of Belgrade received a medical assistance call from a patient with abdominal pain. A 37-year-old female patient declared that the pain had started during the previous night in the periumbilical region, then migrated to the right lower quadrant of the abdomen. The pain was accompanied by nausea and an elevated body temperature of 37.9˚C. The patient's Alvarado Score was 6. The patient was transported to the appropriate healthcare facility, which confirmed the diagnosis of acute appendicitis. Conclusion: In prehospital settings, the most common way of establishing a working diagnosis of acute appendicitis is based solely on medical history and physical examination. Applying the Alvarado Score can be highly valuable, both in facilitating a quicker diagnostic process and in ensuring timely transport of the patient to an appropriate healthcare facility. Narrowing the time frame from the moment a working diagnosis is established to the moment the patient receives appropriate treatment reduces risks of complications, mortality, and unnecessary surgical interventions. 4,5