The Alvarado score (also known as the MANTRELS score) is a clinical decision rule and predictor of the likelihood of acute appendicitis.
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Criteria
migration of pain to the right lower quadrant (+1 point)
anorexia (+1 point)
nausea or vomiting (+1 point)
tenderness in the right lower quadrant (+2 points)
rebound tenderness (+1 point)
elevated temperature (37.3°C or 99.1°F) (+1 point)
leukocytosis >10,000 (+2 points)
shift (of leukocytes) to the left (+1 point)
Score total
5-6 points: possible acute appendicitis
7-8 points: probable acute appendicitis
9-10 points: very probable acute appendicitis
The score can be helpful for decision-making when evaluating nonspecific imaging or equivocal ultrasound findings 2.
The score may be more helpful in ruling out appendicitis with a score <5 than "ruling in" appendicitis with a >7 score 3.
History and etymology
Alfredo Alvarado (fl. 2022) is a retired American-Colombian general surgeon, living in Florida in the United States 4. In 2019 Dr Alvarado published an improved Alvarado score for the diagnosis of acute appendicitis 5.
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