ToolsCalculators
Alvarado score for acute appendicitis
Predicts the likelihood of acute appendicitis (MANTRELS).
Alvarado score for acute appendicitis
Migration of pain to the right lower quadrant
Anorexia
Nausea or vomiting
Right lower quadrant tenderness
Rebound tenderness
Elevated temperature ≥37.3 °C (99.1 °F)
Leukocytosis >10,000/µL
Neutrophil left shift (>75% neutrophils)
Result0 points
Score ≤4: appendicitis unlikely.
When to use
- Risk-stratifying suspected acute appendicitis, especially to identify low-risk patients.
Formula
MANTRELS — Migration 1, Anorexia 1, Nausea/vomiting 1, RLQ tenderness 2, Rebound 1, Elevated temperature 1, Leukocytosis 2, Shift of neutrophils 1. Range 0–10. ≤4 unlikely, 5–6 possible, ≥7 probable.