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Printed on 4/19/2026
For informational purposes only. This is not medical advice.
The Alvarado score is a widely used clinical tool for evaluating suspected acute appendicitis. It combines migration of pain, anorexia, nausea/vomiting, right lower quadrant tenderness, rebound tenderness, fever, leukocytosis, and left shift into a 10-point scale to support risk stratification and next-step imaging or surgical consultation decisions.
Formula: Alvarado = migration(1) + anorexia(1) + nausea/vomiting(1) + RLQ tenderness(2) + rebound(1) + fever(1) + leukocytosis(2) + left shift(1).
Alvarado score was originally developed as a practical appendicitis prediction tool and remains widely used for ED triage support.
The Alvarado score estimates appendicitis probability. Lower scores suggest lower likelihood, intermediate scores indicate diagnostic uncertainty, and higher scores strongly support appendicitis.
It is best used to structure next steps rather than replace imaging or surgical assessment.
Use Alvarado in patients with suspected acute appendicitis, especially in ED or urgent-care triage, to guide observation versus imaging versus surgical consultation.
It can also support serial reassessment when initial presentation is equivocal.
Performance varies by age, sex, symptom duration, and local prevalence. Gynecologic, urinary, and gastrointestinal mimics can produce overlapping findings.
A single score should not override worsening clinical status or peritoneal signs.
For related assessments, see SIRS Criteria, qSOFA Score and NEXUS C-Spine.
Disclaimer: This tool is for educational and informational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider with questions about your health.
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