{"id":2345,"date":"2015-05-14T11:29:05","date_gmt":"2015-05-14T11:29:05","guid":{"rendered":"https:\/\/medicalcriteria.com\/web\/cirap\/"},"modified":"2026-03-20T19:10:05","modified_gmt":"2026-03-20T19:10:05","slug":"cirap","status":"publish","type":"post","link":"https:\/\/medicalcriteria.com\/web\/cirap\/","title":{"rendered":"Alvarado Score for Acute Appendicitis"},"content":{"rendered":"<div class=\"99c380e4b4a7b96c35d7ddf7dcb434e8\" data-index=\"1\" style=\"float: none; margin:0px 0 0px 0; text-align:center;\">\n<script async src=\"https:\/\/pagead2.googlesyndication.com\/pagead\/js\/adsbygoogle.js\"><\/script>\r\n<!-- MC 2019- Horizontal -->\r\n<ins class=\"adsbygoogle\"\r\n     style=\"display:block\"\r\n     data-ad-client=\"ca-pub-0127150553352455\"\r\n     data-ad-slot=\"3806776041\"\r\n     data-ad-format=\"auto\"\r\n     data-full-width-responsive=\"true\"><\/ins>\r\n<script>\r\n     (adsbygoogle = window.adsbygoogle || []).push({});\r\n<\/script>\n<\/div>\n<p>The use of the Alvarado scoring system,\u00a0which includes clinical examination findings and\u00a0laboratory values, is helpful in ruling out appendicitis. Scores range from 1 to 10, with\u00a0higher scores indicating a greater risk of appendicitis.\u00a0When the score is less than 4, appendicitis\u00a0is uncommon, and imaging and other interventions\u00a0can be avoided.<br \/>\n<!--more--><br \/>\n<b>Alvarado Score for Acute Appendicitis<\/b><\/p>\n<table style=\"border-collapse: collapse; width: 100%;\" border=\"1\">\n<tbody>\n<tr valign=\"TOP\">\n<td width=\"350\"><b>Component Possible<\/b><\/td>\n<td style=\"text-align: center;\" width=\"142\"><b>Points<\/b><\/td>\n<\/tr>\n<tr>\n<td colspan=\"2\" valign=\"TOP\" width=\"579\">Symptoms<\/td>\n<\/tr>\n<tr valign=\"TOP\">\n<td width=\"429\">Migration of pain to the right lower quadrant<\/td>\n<td style=\"text-align: center;\" width=\"142\">1<\/td>\n<\/tr>\n<tr valign=\"TOP\">\n<td width=\"429\">Anorexia<\/td>\n<td style=\"text-align: center;\" width=\"142\">1<\/td>\n<\/tr>\n<tr valign=\"TOP\">\n<td width=\"429\">Nausea or vomiting<\/td>\n<td style=\"text-align: center;\" width=\"142\">1<\/td>\n<\/tr>\n<tr>\n<td colspan=\"2\" valign=\"TOP\" width=\"579\">Signs<\/td>\n<\/tr>\n<tr valign=\"TOP\">\n<td width=\"429\">Tenderness in the right lower quadrant<\/td>\n<td style=\"text-align: center;\" width=\"142\">2<\/td>\n<\/tr>\n<tr valign=\"TOP\">\n<td width=\"429\">Rebound pain<\/td>\n<td style=\"text-align: center;\" width=\"142\">1<\/td>\n<\/tr>\n<tr valign=\"TOP\">\n<td width=\"429\">Elevated temperature<\/td>\n<td style=\"text-align: center;\" width=\"142\">1<\/td>\n<\/tr>\n<tr>\n<td colspan=\"2\" valign=\"TOP\" width=\"579\">Laboratory findings<\/td>\n<\/tr>\n<tr valign=\"TOP\">\n<td width=\"429\">Leukocytosis<\/td>\n<td style=\"text-align: center;\" width=\"142\">2<\/td>\n<\/tr>\n<tr valign=\"TOP\">\n<td width=\"429\">Left shift\u2020<\/td>\n<td style=\"text-align: center;\" width=\"142\">1<\/td>\n<\/tr>\n<tr valign=\"TOP\">\n<td width=\"429\">Total score<\/td>\n<td style=\"text-align: center;\" width=\"142\">10<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p>* Points are ascribed to each symptom, sign, and laboratory finding; patients\u00a0with a score of less than 4 are unlikely to have appendicitis.<br \/>\n\u2020 A left shift is an increase in levels of immature neutrophil forms circulating in\u00a0the peripheral blood.<\/p>\n<p>&nbsp;<\/p>\n<p><b>References:<\/b><\/p>\n<ol>\n<li>Flum D. Acute Appendicitis: Appendectomy or the \u201cAntibiotics First\u201d Strategy.\u00a0N Engl J Med. 2015 May 14;372(20):1937-43.\u00a0<a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/25970051\/\" target=\"_blank\" rel=\"noopener noreferrer\">[Medline]<\/a><\/li>\n<li>Ohle R, O\u2019Reilly F, O\u2019Brien KK, Fahey\u00a0T, Dimitrov BD. The Alvarado score for\u00a0predicting acute appendicitis: a systematic\u00a0review. BMC Med 2011;9:139.\u00a0<a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/22204638\/\" target=\"_blank\" rel=\"noopener noreferrer\">[Medline]<\/a><\/li>\n<li>Alvarado A. A practical score for the\u00a0early diagnosis of acute appendicitis. Ann\u00a0Emerg Med 1986;15:557-64.\u00a0<a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/3963537\/\" target=\"_blank\" rel=\"noopener noreferrer\">[Medline]<\/a><\/li>\n<li>Kamal MM, Al Reshidi BM, Bedier HM, Albariqi AO, Almotrafie WA, Alshreef BS, Wahbi MO, Aly W, Alyami SA, Abdallah H, Alharbi SA. Diagnostic Accuracy of Point-of-Care Ultrasound (POCUS) for Suspected Acute Appendicitis in Pediatric and Adult Emergency Departments: A Systematic Review and Meta-Analysis. Cureus. 2026 Feb 12;18(2):e103503. <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/41841098\/\" target=\"_blank\" rel=\"noopener\">[Medline]<\/a><\/li>\n<\/ol>\n<p>&nbsp;<\/p>\n<p>Created May 14, 2015.<br \/>\nUp-date Mar 20, 2026.<\/p>\n\n<div style=\"font-size: 0px; height: 0px; line-height: 0px; margin: 0; padding: 0; clear: both;\"><\/div>","protected":false},"excerpt":{"rendered":"<p>Sorry, this entry is only available in Espa\u00f1ol.<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_lmt_disableupdate":"no","_lmt_disable":"no","_exactmetrics_skip_tracking":false,"_exactmetrics_sitenote_active":false,"_exactmetrics_sitenote_note":"","_exactmetrics_sitenote_category":0,"footnotes":""},"categories":[165],"tags":[231,230,806,807,808,450,494,507],"class_list":["post-2345","post","type-post","status-publish","format-standard","hentry","category-surgery","tag-acute","tag-aguda","tag-alvarado","tag-apendicitis","tag-appendicitis","tag-score","tag-sistema","tag-system"],"modified_by":"Guillermo Firman","_links":{"self":[{"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/posts\/2345","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/comments?post=2345"}],"version-history":[{"count":4,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/posts\/2345\/revisions"}],"predecessor-version":[{"id":10723,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/posts\/2345\/revisions\/10723"}],"wp:attachment":[{"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/media?parent=2345"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/categories?post=2345"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/tags?post=2345"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}