A COMPARATIVE STUDY BETWEEN TZANAKIS SCORING SYSTEM AND ALVARADO SCORING SYSTEM IN DIAGNOSIS

Background: Acute appendicitis is one of the most common surgical emergency, and its accurate diagnosis is crucial to prevent complications and reduce negative appendectomy rates. Clinical scoring systems, such as the Alvarado and Tzanakis scores, aid in diagnosis, but their comparative accuracy remains under evaluation.

Aim: To compare the diagnostic accuracy of the Tzanakis scoring system with the Alvarado scoring system in suspected acute appendicitis cases, using histopathology as the gold standard.

Methods: This prospective, hospital-based study was conducted at a tertiary care center over one year and included 153 patients aged 11–60 years presenting with clinically suspected acute appendicitis. Both Tzanakis and Alvarado scores were calculated preoperatively. All patients underwent appendectomy, and histopathological examination confirmed the diagnosis. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), diagnostic accuracy, and receiver operating characteristic (ROC) curve analysis were performed for both scoring systems.

Results: Tzanakis score ≥8 was observed in 83% of patients, while 69.9% had Alvarado score ≥7. Tzanakis demonstrated higher sensitivity (96.8%), specificity (75.9%), PPV (94.5%), NPV (84.6%), and diagnostic accuracy (92.8%) compared to Alvarado (77.4%, 62.1%, 89.7%, 39.1%, and 74.5%, respectively). ROC analysis showed AUC of 0.948 for Tzanakis versus 0.726 for Alvarado.

Conclusion: The Tzanakis score outperforms the Alvarado score in diagnosing acute appendicitis and should be preferred when ultrasonography is available.