Alvarado score

The Alvarado score is a clinical decision rule and predictor of the likelihood of acute appendicitis:

  • right lower quadrant tenderness (+2)
  • elevated temperature (37.3°C or 99.1°F) (+1)
  • rebound tenderness (+1)
  • migration of pain to the right lower quadrant (+1)
  • anorexia (+1)
  • nausea or vomiting (+1)
  • leucocytosis >10,000 (+2)
  • leucocytosis left shift (+1)

Score total:

  • 5-6 compatible with acute appendicitis
  • 7-8 probable acute appendicitis
  • 9-10 very probable acute appendicitis

The score can be useful for decision making when evaluating nonspecific imaging or equivocal ultrasound findings 2.

The score may be more useful for ruling out appendicitis with a score <5, than "ruling in" appendicitis with a >7 score 3.

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rID: 48425
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