Alvarado score (acute appendicitis)

Surgery / Emergency

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Next steps

Recommendations appear after you calculate.

Clinical evidence

Symptoms (1 pt each): migratory RLQ pain, anorexia, nausea/vomiting. Signs (2 pt each): RLQ tenderness, rebound tenderness, fever ≥37.3°C. Labs: WBC >10k (2 pt), left shift >75% (1 pt).
  • Sensitivity 81–85%, specificity 74–85%
  • PPV 92% for score ≥7
  • NPV 93% for score <4
  • Most accurate in young adult males
  • Alvarado A. Ann Emerg Med 1986;15:557-64
  • Ohle R et al. (2011) — systematic review
  • WSES Jerusalem guidelines (2016)

About the creator

Developed by Dr. Alfredo Alvarado in 1986 at Nazareth Hospital, Philadelphia.

Alvarado A. Ann Emerg Med 1986;15:557-64

AskCPG — Malaysian Clinical Practice Guidelines