Journal of AdvancedMedical and Dental Sciences Research

Background: The Alvarado score and pediatric appendicitis scoring systems establish a threshold score that guides decision-making. Above this score, surgery is typically recommended, while below it, observation suffices. This study was conducted among pediatric patients presenting in a surgical emergency setting with right lower abdominal pain and exhibiting signs and symptoms suggestive of acute appendicitis. Methods: This study was carried out on children who presented in a surgical emergency setting with right lower abdominal pain and displayed signs and symptoms indicative of acute appendicitis. Each patient enrolled in the study was assigned clinical scores using both the Alvarado scoring system and the pediatric appendicitis scoring system. Statistical analyses were performed for both scoring systems with a focus on the cutoff score of 7. Results: The study included a total of 200 patients, comprising 140 males and 60 females. Among these, 94 patients were categorized as part of the operated group (scoring seven or more on the PAS/Alvarado systems), and 106 patients were part of the observational group (scoring less than seven). Within the observational group, 78 patients (73.58%) experienced a successful resolution of symptoms during observation, without any complications, while 28 patients (26.41%) required surgery due to an increase in their PAS/Alvarado scores during the observational period.Out of the total 200 patients, 122 underwent surgery, with 94 in the "seven or more than seven" group and 28 in the "less than seven" group. Among these operated patients, the histopathology reports confirmed acute appendicitis in 100 cases and ruled out appendicitis in 22 cases.Using the Alvarado scoring system, 86 patients fell into the "seven or more than seven" group, while 36 patients were classified as "less than seven." At the cutoff value of 7, the Alvarado score achieved 78 accurate diagnoses of appendicitis and 8 cases of unnecessary appendectomies. Conclusion: The diagnostic accuracy values indicate that the pediatric appendicitis score (PAS) outperformed the Alvarado score in diagnosing acute appendicitis in the pediatric population.