Table 2: Clinical risk scores for suspected acute appendicitis [47,48]. PAS = pediatric appendicitis score. Elevation in temperature for the Alvarado score is defined at temperature ≥ 37.5 °C, and for the PAS as ≥ 38 °C. The ruptured appendicitis score [50] has a sensitivity is 47 and specificity 98 for ruptured appendicitis at a score of 9.
| Alvarado score | Pediatric Appendicitis Score (PAS) | |
| Symptoms | ||
| Migration of pain to the right lower quadrant | 1 | 1 |
| Nausea/vomiting | 1 | 1 |
| Anorexia | 1 | 1 |
| Signs | ||
| Right lower quadrant tenderness | 2 | 2 |
| Rebound tenderness | 1 | |
| Elevation in temperature | 1 | 1 |
| Cough/hopping/percussion tenderness in the right lower quadrant | 2 | |
| Laboratory tests | ||
| Leukocytes ≥ 10,000/μl | 2 | 1 |
| Polymorphonuclear neutrophilia ≥ 75% | 1 | 1 |
| Total score | 10 | 10 |
Risk of appendicitis
| Low risk: |
| Alvarado score 0-4 |
| PAS score 0-3 |
| Intermediate risk: |
| Alvarado score 5-6 |
| PAS score 4-6 |
| High risk: |
| Alvarado score 7-10 |
| PAS score 7-10 |
| Ruptured appendicitis score | |
| Variable | Points |
| Generalized tenderness | 4 |
| Abscess on imaging | 3 |
| Duration > 48 hours | 3 |
| WBC > 19,400 cells/μl | 2 |
| Fecalith on imaging | 1 |
| Total | 13 |