Tzanaki’s Score Vs Modified Alvarado’s Score In Diagnosing Acute Appendicitis: A Comparative Study In A Tertiary Care Hospital
Abstract
Introduction: Acute appendicitis is commonly diagnosed when a patient presents with pain in right iliac fossa. Various Scoring systems are used to diagnose acute appendicitis and mainly include the presenting signs and symptoms, but are not acceptable for patients. The purpose of this study was to assess effectiveness of modified Alvarado score and Tzanaki’s Score in the diagnosis of acute appendicitis.Methods: A prospective observational study was done in department of General Surgery JLN Medical College Hospital, Ajmer which incorporated 200 patients presenting with the signs and symptoms of acute appendicitis. Patients were evaluated by Modified Alvarado score and Tzanaki’s Score during admission and based on the treating surgeon’s decision, were operated. Finally, the score was compared with the diagnosis done by histopathological examination of the operated specimen.
Results: The sensitivity & specificity of Modified Alvarado Score was 84.26% & 72.7% respectively with a positive predictive value of 96.15% & negative predictive value of 36.3%. The sensitivity and specificity of Tzanaki’s score was 88.2% and 72.7% respectively with a positive predictive value of 96.31% and negative predictive value of 43.24%. The diagnostic accuracy of Alvarado score was 83% and that of Tzanaki’s score was 86.5%.
Conclusion: Tzanaki’s scoring system can be used as an effective modality in the diagnosis of acute appendicitis. There is increased sensitivity and diagnostic accuracy in Tzanaki’s scoring when compared to modified Alvarado score.
References
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14. Malla BR, Batajoo H. Comparison of Tzanaki’s score vs Alvarado score in the effective diagnosis of acute appendicitis. Kathmandu Univ Med J (KUMJ). 2014;12(45):48-50.
15. Malik AA, Mir MF, Khurshid SU, Wani I, Dagga R. Modified Alvarado Score Versus Tzanaki’s Score for Diagnosing Acute Appendicitis in Changing Clinical Practice. Int J Clin Exp Med Sci. 2016;2(5):90-3.
16. Shashikala V, Hegde H, Victor AJ. Comparative study of Tzanaki’s score vs Alvarado score in the effective diagnosis of acute appendicitis. Int J Biomed and Adv Res 2016;7(9):418-20.
17. Yu SH, Kim CB, Park JW, Kim MS, Radosevich DM. Ultrasonography in the diagnosis of appendicitis: evaluation by meta-analysis. Korean J Radiol. 2005; 6(4):267-77.
2. Bharath B, Varma VA, Reddy GS. A comparative study of tzanaki’s score versus alvarado score in acute appendicitis at a rural hospital. J Evid Based Med Healthc. 2020; 7(35), 1848-51.
3. Cuschieri A, Hanna G. Essential surgical practice: higher surgical training in general surgery. 5th edn. CRC Press 2015.
4. Kalan M, Talbot D, Cunliffe WJ, Rich AJ. Evaluation of the modified Alvarado score in the diagnosis of acute appendicitis: a prospective study. Ann R Coll Surg. 1994; 11:418–9.
5. Anupriya R, Babu CPG, Rajan KV. A comparison of Tzanaki’s and Alvarado scoring system in the diagnosis of acute appendicitis. International Surgery Journal. 2019;6(6):2080-83.
6. Saidi RF, Ghasemi M. Role of Alvarado score in diagnosis and treatment of suspected acute appendicitis. Am J Emerg Med. 2000; 18:230-1.
7. Flum DR, Koepsell T. The clinical and economic correlates of misdiagnosed appendicitis. Arch Surg. 2002; 37:799-804.
8. Bergeron E. Clinical judgment remains of great value in the diagnosis of acute appendicitis. Can J Surg.2006; 49(2):96–100.
9. Andersson RE. Meta-analysis of the clinical and laboratory diagnosis of appendicitis. Br J Surg. 2004;91(1):28–37
10. Dharmarajan S, Arvindraj R. A study comparing modified Alvarado score and Tzanakis score for diagnosing acute appendicitis. IAIM, 2019; 6(5): 137-141.
11. MCox MR, McCall JL, Padbury RT, Wilson TG, Wattchow DA, Toouli J. Laparoscopic surgery in women with clinical diagnosis of acute appendicitis. Med J Aust. 1995; 162:130.
12. Fenyo G, Lindenberg G, Blind P, Enchsson L, Oberg A. diagnostic decision support in suspected acute appendicitis. Validation of simplified scoring system. 1997; 163(11):831-8.
13. Tzanakis NE, Efstathiou SP, Danulidis K, Rallis GE, Tsioulos DI, Chatzivasiliou A, Peros G, Nikiteas NI. A new approach to accurate diagnosis of acute appendicitis. World J Surg. 2005 Sep 1;29(9):1151-6.
14. Malla BR, Batajoo H. Comparison of Tzanaki’s score vs Alvarado score in the effective diagnosis of acute appendicitis. Kathmandu Univ Med J (KUMJ). 2014;12(45):48-50.
15. Malik AA, Mir MF, Khurshid SU, Wani I, Dagga R. Modified Alvarado Score Versus Tzanaki’s Score for Diagnosing Acute Appendicitis in Changing Clinical Practice. Int J Clin Exp Med Sci. 2016;2(5):90-3.
16. Shashikala V, Hegde H, Victor AJ. Comparative study of Tzanaki’s score vs Alvarado score in the effective diagnosis of acute appendicitis. Int J Biomed and Adv Res 2016;7(9):418-20.
17. Yu SH, Kim CB, Park JW, Kim MS, Radosevich DM. Ultrasonography in the diagnosis of appendicitis: evaluation by meta-analysis. Korean J Radiol. 2005; 6(4):267-77.
Published
2023-12-31
How to Cite
RAJPURA, Ashok Kumar et al.
Tzanaki’s Score Vs Modified Alvarado’s Score In Diagnosing Acute Appendicitis: A Comparative Study In A Tertiary Care Hospital.
J Soc Surg Nep, [S.l.], v. 26, n. 2, p. 70-73, dec. 2023.
ISSN 2392-4772.
Available at: <https://www.jssn.org.np/index.php?journal=jssn&page=article&op=view&path%5B%5D=https%3A%2F%2Fdoi.org%2F10.3126%2Fjssn.v26i2.63627>. Date accessed: 23 jan. 2025.
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