Alvarado Score Calculator

Health

The Alvarado Score Calculator adds up the eight MANTRELS clinical and lab findings to estimate the likelihood of acute appendicitis. The total ranges from 0 to 10, with higher scores indicating a greater probability.

Rates and fees change frequently. Always confirm the current figures with the official authority before relying on this result.

Formula

Alvarado Score = Sum of MANTRELS component points (0-10)
  • MANTRELS stands for Migratory pain, Anorexia, Nausea, Tenderness in the RLQ, Rebound, Elevated temperature, Leukocytosis and Shift of white cells.
  • Most items score 1 point; right-lower-quadrant tenderness and leukocytosis score up to 2, for a maximum of 10.
  • Interpretation: 1–4 is low probability, 5–6 is possible (consider observation), and 7–10 is probable appendicitis.
  • This is a decision-support aid; imaging and clinical judgment guide the final diagnosis.

Example Calculation

Inputs
  • Migratory RLQ Pain (0 or 1): 1
  • Anorexia (0 or 1): 1
  • Nausea/Vomiting (0 or 1): 1
  • RLQ Tenderness (0-2): 2
  • Rebound Pain (0 or 1): 1
  • Fever (0 or 1): 1
  • Leukocytosis (0-2): 2
  • Left Shift (0 or 1): 1

A patient with all features present scores 1+1+1+2+1+1+2+1 = 10, indicating a high probability of acute appendicitis.

Frequently asked questions

What is the Alvarado score?
It is an eight-item clinical scoring system (MANTRELS) used to estimate the likelihood of acute appendicitis.
How is the score interpreted?
1–4 suggests low probability, 5–6 is compatible (often observed or imaged), and 7–10 indicates probable appendicitis.
What does MANTRELS stand for?
Migratory pain, Anorexia, Nausea/vomiting, Tenderness in the right lower quadrant, Rebound pain, Elevated temperature, Leukocytosis and Shift of neutrophils.
Which items score 2 points?
Right-lower-quadrant tenderness and leukocytosis each contribute up to 2 points; the others are worth 1 each.
Does a high score confirm appendicitis?
No. It raises suspicion and guides next steps, but diagnosis relies on clinical assessment and often imaging.