Estimates the probability of acute appendicitis using symptoms, signs, and basic labs.
What is the Alvarado Score?
The Alvarado Score, developed by Alfredo Alvarado in 1986, combines symptoms, signs, and basic labs into a 10-point score estimating the probability of acute appendicitis.
Interpretation
| Score | Probability |
|---|
| ≤4 | Unlikely |
| 5–6 | Equivocal — possible appendicitis |
| 7–10 | Probable — surgical consultation |
Limitations
Performance varies by age and sex — it tends to be less reliable in women (due to gynecological mimics) and young children. It supports, but doesn't replace, clinical judgment and imaging where indicated.
References
Alvarado A. A practical score for the early diagnosis of acute appendicitis. Ann Emerg Med. 1986.
Frequently Asked Questions
Can Alvarado Score rule out appendicitis on its own?
No — a low score makes appendicitis less likely but doesn't fully exclude it. Clinical judgment and, often, imaging are still used alongside the score.
Is Alvarado Score equally accurate in everyone?
No — performance varies somewhat by age and sex, performing less well in women and young children, so use it as one input rather than a stand-alone diagnostic tool.
What replaced left shift if a differential isn't available?
Some modified versions of the score omit the left-shift criterion when a differential count isn't readily available, scoring out of a slightly adjusted maximum.