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surgery emergency-medicine

Alvarado Score (Appendicitis)

Estimates probability of acute appendicitis using clinical and laboratory findings. Guides CT scan and surgical referral decisions. Also known as MANTRELS score.

Used in: Acute Appendicitis

Score interpretation

Low probability of appendicitis (<=30%)

→ Discharge with safety netting; return if worsening; outpatient USS if persisting; no emergency CT required

Equivocal — CT or USS required

→ Active observation; CRP + repeat WBC in 6h; CT abdomen with IV contrast or USS; surgical consult; analgesia (does not mask peritonism)

High probability of appendicitis (>=74%)

→ Urgent surgical review; IV access + fluids; analgesia; consider CT to exclude other pathology; consent for laparoscopic appendicectomy; NBM

Interpretation bands for the Alvarado Score. Apply clinical judgement and local guidance.

References

Related

Curated clinical cross-links plus same-class fallbacks.

Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.