The Alvarado (MANTRELS) score is used to predict acute appendicitis. A patient scores 7 out of 10. According to the scoring system, this score suggests:

• A Low probability — discharge with analgesia
• B Moderate probability — active observation + re-evaluation
• C Diagnostic certainty of appendicitis — immediate appendicectomy
• D High probability — strong consideration for surgical intervention ✓

Explanation

Alvarado score: 0–4 = low probability (unlikely appendicitis, discharge); 5–6 = equivocal (observe, CT/US if needed); 7–10 = high probability (surgical referral/appendicectomy likely). A score of 7–10 indicates high likelihood of acute appendicitis and strongly favors surgical intervention. For equivocal scores (5–6), CT abdomen has near 100% sensitivity/specificity and is recommended to confirm diagnosis before surgery, avoiding negative appendicectomy rate.

Reference: Bailey & Love's Short Practice of Surgery, 27th ed.

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Written and medically reviewed by the StethoPrep medical team.