EVALUATING THE EFFECTIVENESS OF THE MODIFIED ALVARADO SCORING SYSTEM (MASS) AND APPENDICITIS INFLAMMATORY RESPONSE SCORE (AIRS) IN DIAGNOSING ACUTE APPENDICITIS: A COMPARATIVE ANALYSIS

Abstract

Background
Acute appendicitis is one of the most common emergency surgical conditions. Despite advancements in medical technology, its diagnosis remains primarily clinical. Delayed or inaccurate diagnosis can lead to complications such as perforation or unnecessary surgery. The Modified Alvarado Scoring System (MASS) and Appendicitis Inflammatory Response Score (AIRS) are widely used scoring systems for preoperative evaluation. This study compares the effectiveness of these two scoring systems in diagnosing acute appendicitis.
Materials & Methods
This prospective study was conducted at Meenakshi Medical College Hospital and Research Institute. A total of 20 patients with suspected acute appendicitis were evaluated using both MASS and AIRS. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and diagnostic accuracy were calculated for each scoring system. The histopathological examination (HPE) served as the gold standard for confirmation.
Results
MASS demonstrated a sensitivity of 60%, specificity of 85%, PPV of 90%, and NPV of 50%, with an overall diagnostic accuracy of 70%. AIRS, with a cutoff score >8, showed superior performance with a sensitivity of 80%, specificity of 95%, PPV of 95%, and NPV of 70%, achieving an overall diagnostic accuracy of 80%. The higher sensitivity and NPV of AIRS suggest that it is a more reliable tool for reducing unnecessary appendectomies.
Conclusion
AIRS proved to be more effective than MASS in diagnosing acute appendicitis due to its higher sensitivity, specificity, and diagnostic accuracy. Its high NPV suggests a reduced risk of negative appendectomy, thereby preventing unnecessary surgeries and avoiding additional financial burden. Further studies with larger sample sizes are needed to validate these findings.