Alvarado score

What is the Alvarado score and is it useful in diagnosis? 

Developed more than 20 years ago, the Alvarado score has found more widespread usage in the past decade. It is a 10-point risk stratification system with points based on findings such as anorexia and right lower quadrant pain, as well as laboratory studies like leukocytosis and left shift of white blood cells (WBCs) (see online calculator at

Although scores of 7 to 10 predict a 93% appendicitis rate, it tends to over-predict the rates of appendicitis in women and has shown some inconsistencies in children. Its best use may be in ruling out appendicitis in those with low scores (less than 4).


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