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Alvarado Score — Appendicitis
MANTRELS criteria for suspected acute appendicitis in adults. Score 0–10 stratifies probability and guides imaging vs. surgical referral.
Σ points from 8 criteria (max 10). RLQ tenderness and leukocytosis weighted ×2.
Symptoms
Signs
Labs
Total score
0/ 10
Interpretation
Low probability — discharge likely safe
0–3 Low probability — discharge likely safe
4–6 Possible — observe / imaging (CT, US)
7–8 Probable — surgical referral
9–10 Very probable — urgent surgical referral
Alvarado is less reliable in children, pregnancy, and elderly patients. Combine with clinical assessment and imaging where indicated.