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