Alvarado Score

Clinical prediction of acute appendicitis

Indication

id: migration; label: Migration of pain to RLQ; type: yesno; points: 1
id: anorexia; label: Anorexia; type: yesno; points: 1
id: nausea; label: Nausea/vomiting; type: yesno; points: 1
id: rlq_tender; label: RLQ tenderness; type: yesno; points: 2
id: rebound; label: Rebound tenderness; type: yesno; points: 1
id: temp; label: Elevated temperature (>37.3°C / 99.1°F); type: yesno; points: 1
id: leukocytosis; label: Leukocytosis (WBC >10,000); type: yesno; points: 2
id: left_shift; label: Left shift (>75% neutrophils); type: yesno; points: 1

function(score) { if (score <= 4) return { risk: score + '/10', tier: 'Low Risk', action: 'Appendicitis unlikely. Discharge with return precautions.', color: 'green' }; if (score <= 6) return { risk: score + '/10', tier: 'Equivocal', action: 'CT scan recommended for further evaluation.', color: 'yellow' }; return { risk: score + '/10', tier: 'High Probability', action: 'Appendicitis likely. Surgical consult +/- CT.', color: 'red' }; }

MANTRELS mnemonic: Migration, Anorexia, Nausea, Tenderness, Rebound, Elevation, Leukocytosis, Shift
Score ≤4: appendicitis unlikely — consider discharge
Score 5-6: CT scan recommended
Score ≥7: surgical consult — high probability of appendicitis

Alvarado A, Ann Emerg Med 1986; Ohle et al., BMC Surgery 2011. Last reviewed: 2024-10-15