Alvarado score

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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)
  • leukocytosis >10,000 (+2)
  • leukocytosis 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 .

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

History and etymology

Alfredo Alvarado (fl. 2020) is an American-Colombian general surgeon, who is still practising in Florida in the United States .