Citation, DOI, disclosures and article data
At the time the article was created Matt A. Morgan had no recorded disclosures.View Matt A. Morgan's current disclosures
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The Alvarado score is a clinical decision rule and predictor of the likelihood of acute appendicitis.
It is also known as the MANTRELS score from the initial letters of the criteria.
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- migration of pain to the right lower quadrant (+1)
- anorexia (+1)
- nausea or vomiting (+1)
- tenderness in the right lower quadrant (+2)
- rebound tenderness (+1)
- elevated temperature (37.3°C or 99.1°F) (+1)
- leukocytosis >10,000 (+2)
- shift (of leukocytes) to the left (+1)
- 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.
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.
- 1. Alvarado A. A Practical Score for the Early Diagnosis of Acute Appendicitis. Ann Emerg Med. 1986;15(5):557-64. doi:10.1016/s0196-0644(86)80993-3 - Pubmed
- 2. Athans B, Depinet H, Towbin A, Zhang Y, Zhang B, Trout A. Use of Clinical Data to Predict Appendicitis in Patients with Equivocal US Findings. Radiology. 2016;280(2):557-67. doi:10.1148/radiol.2016151412 - Pubmed
- 3. Ohle R, O'Reilly F, O'Brien K, Fahey T, Dimitrov B. The Alvarado Score for Predicting Acute Appendicitis: A Systematic Review. BMC Med. 2011;9(1):139. doi:10.1186/1741-7015-9-139 - Pubmed
- 4. Alvarado A. How to Improve the Clinical Diagnosis of Acute Appendicitis in Resource Limited Settings. World J Emerg Surg. 2016;11(1):16. doi:10.1186/s13017-016-0071-8 - Pubmed
- 5. Alfredo A. Improved Alvarado Score (MANTRELS) for the Early Diagnosis of Acute Appendicitis. Int J Surg Res Pract. 2019;6(1). doi:10.23937/2378-3397/1410098