What is the Alvarado (MANTRELS) score for risk stratification of pediatric appendicitis?

Updated: Oct 25, 2018
  • Author: Adam C Alder, MD; Chief Editor: Carmen Cuffari, MD  more...
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The MANTRELS score is based on the following 8 variables:

  • Migration of pain to RLQ

  • Anorexia

  • Nausea/vomiting

  • Tenderness in RLQ

  • Rebound pain

  • Elevated temperature (>37.3° C)

  • Leukocytosis (>10,000/µL)

  • Left shift

Schneider et al found that an Alvarado score of 7 or higher yielded a sensitivity of 73% and a specificity of 80%. [17] Use of this scoring system is limited to risk stratification of suspected appendicitis in children.

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