A Study Comparing Modified Alvarado Score and Tzanakis Score For Diagnosing Acute Appendicitis

Authors

  • Hankey Yadav
  • Praveen Agrawal
  • Shaik Hussain
  • Talaviya Dhananjay

Keywords:

Alvarado, tzanakis, diagnosing, acute & appendicitis

Abstract

Background & Methods: The aim of the study is to compare the accuracy of the Modified Alvarado Score and Tzanakis Score in Diagnosing Acute Appendicitis. Informed written consent was obtained from all patients. This prospective, non-randomized study included patients admitted to the Department of General Surgery at KD Medical College, Mathura, over two years, with clinical suspicion of acute appendicitis who underwent appendicectomy.

Results: 60 had a Tzanakis score of more than 8, with 56 having a Modified Alvarado score of more than 7. The remaining 18 cases had a Tzanakis score of less than 8, with 15 having a Modified Alvarado score of less than 7

Conclusion: The study demonstrates that both the MAS and the Tzanakis Score are reliable and effective tools for the preoperative diagnosis of acute appendicitis. However, the Tzanakis Score offers superior sensitivity and specificity, particularly in cases where the diagnosis is uncertain. Its higher accuracy, as evidenced by its correlation with histopathological confirmation, suggests that it may be a preferred diagnostic tool in clinical settings. While the MAS remains a useful tool, the Tzanakis Score's broader scoring range allows for finer diagnostic stratification, potentially reducing unnecessary appendectomies and improving patient outcomes

Downloads

Download data is not yet available.

References

Prather, C. (2012). Inflammatory and Anatomic Diseases of the Intestine, Peritoneum, Mesentery, and Omentum. Goldman’s Cecil Medicine, 921–928. doi:10.1016/b978-1-4377-1604-7.00144-5

Guan, Linjing et al. “The global, regional, and national burden of appendicitis in 204 countries and territories, 1990-2019: a systematic analysis from the Global Burden of Disease Study 2019.” BMC gastroenterology vol. 23,1 44. 22 Feb. 2023, doi:10.1186/s12876-023-02678-7

Lotfollahzadeh S, Lopez RA, Deppen JG. Appendicitis. [Updated 2024 Feb 12]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK493193/

Bessoff, Kovi E., and Joseph D. Forrester. "Appendicitis in low-resource settings." Surgical Infections 21.6 (2020): 523-532.

Alvarez-Lozada, Luis Adrian, et al. "Clinical scores for acute appendicitis in adults: A systematic review and meta-analysis of diagnostic accuracy studies." The American Journal of Surgery 240 (2025): 116123.

Peyvasteh, Mehran, et al. "Modified Alvarado score in children with diagnosis of appendicitis." ABCD. ArquivosBrasileiros de CirurgiaDigestiva (São Paulo) 30.1 (2017): 51-52.

Saleem, Muhammad Mudasir, et al. "TZANAKIS SCORE AS DIAGNOSTIC TOOL FOR ACUTE APPENDICITIS." Pakistan Armed Forces Medical Journal 67.SUPPL-1 (2017): S10-14.

Awan, Abdul Rafeh, et al. "A comparison of the accuracy of Tzanakis and Modified Alvarado Score in the diagnosis of acute appendicitis: A systematic review and meta-analysis." The Surgeon (2024).

Sharma, Dron, and R. S. Koujalagi. "A comparative study to assess efficacy of Tzanakis score and Modified Alvarado score for effective diagnosis of patients with acute appendicitis at a tertiary care centre in North Karnataka: a one-year prospective analytical study." International Surgery Journal 7.6 (2020): 1742-1745." (2020).

Datta, Sekuboyina Kiran, Rama Chandra Mohan, and Peela Laxmi Teja. "Comparative Study of Tzanakis Score VsModified Alvarado Score in the Effective Diagnosis of Acute Appendicitis."

Korkut, Mustafa et al. “Accuracy of Modified Alvarado , Eskelinen, Ohmann, RIPASA and Tzanakis Scores in Diagnosis of Acute Appendicitis; a Cross-sectional Study.” Archives of academic emergency medicine vol. 8,1 e20. 13 Mar. 2020

. Khorwal B, Choudhary D, Yadav DK, Rajpura AK. Modified Alvarado score versus Tzanaki’s Score in diagnosing acute appendicitis: An observational study. Natl J Physiol Pharm Pharmacol. 2022; 12(11): 1871-1874. doi:10.5455/njppp.2022.12.094562022009102022 (2022)

Rajpura, A. K., Choudhary, D., Khorwal, B., Bhutra, S., Yadav, D. K., & Bansal, K. (2023). Tzanaki’s Score Vs Modified Alvarado ’s Score In Diagnosing Acute Appendicitis: A Comparative Study In A Tertiary Care Hospital. Journal of Society of Surgeons of Nepal, 26(2), 70–73. https://doi.org/10.3126/jssn.v26i2.63627 (2023)

Downloads

Published

2025-05-29

How to Cite

1.
Yadav H, Agrawal P, Hussain S, Dhananjay T. A Study Comparing Modified Alvarado Score and Tzanakis Score For Diagnosing Acute Appendicitis. J Neonatal Surg [Internet]. 2025May29 [cited 2025Sep.21];14(28S):549-54. Available from: https://www.jneonatalsurg.com/index.php/jns/article/view/6723

Issue

Vol. 14 No. 28S (2025): Journal of Neonatal Surgery

Section

Original Article

License

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

You are free to:

  • Adapt — remix, transform, and build upon the material for any purpose, even commercially.

Terms:

  • Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.
  • No additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.