DIAGNOSTIC ACCURACY OF COMBINED ULTRASOUND, MODIFIED ALVARADO SCORE, AND CRP VERSUS CT SCAN IN APPENDICITIS: A COMPARATIVE CROSS-SECTIONAL STUDY WITH HISTOPATHOLOGICAL VALIDATION riyapareek516@gmail.com

 

DIAGNOSTIC ACCURACY OF COMBINED ULTRASOUND, MODIFIED ALVARADO SCORE, AND CRP VERSUS CT SCAN IN APPENDICITIS: A COMPARATIVE CROSS-SECTIONAL STUDY WITH HISTOPATHOLOGICAL VALIDATION

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India

Poster with Discussion

Acute appendicitis is a leading cause of surgical emergencies. While CT scans offer high diagnostic accuracy, their cost and radiation exposure pose challenges, especially in young or pregnant patients. This study evaluates the diagnostic performance of a combination of Ultrasound (USG), Modified Alvarado Score (MAS), and C-Reactive Protein (CRP) as an alternative to CT scans, using histopathology as the gold standard. Objective: To compare the diagnostic accuracy of: CT scan, A combination of USG + MAS + CRP (MAC), against histopathological examination.

This hospital-based cross-sectional study included 40 clinically suspected appendicitis patients aged 12–60 years. Data were collected through clinical assessment (MAS), imaging (USG and CT), laboratory testing (CRP), and confirmed post-operatively by histopathology. Diagnostic accuracy parameters—sensitivity, specificity, PPV, NPV, and overall accuracy—were calculated for CT and MAC approaches.

Out of 40 patients, 26 (65%) were confirmed appendicitis cases via histopathology. CT scan showed a sensitivity of 84.6%, specificity of 85.7%, and overall accuracy of 85%. MAC combination showed a higher sensitivity of 92.3%, but lower specificity (64.3%) and accuracy (82.5%).
MAC had a PPV of 82.8% and NPV of 81.8%, whereas CT had a PPV of 91.7% and NPV of 75%.

The combination of USG, MAS, and CRP demonstrates high sensitivity and acceptable diagnostic accuracy, making it a viable, safer, and more accessible alternative to CT, particularly in resource-limited settings or populations where radiation is a concern.