To assess the diagnostic accuracy of Alvarado scoring system by placing variables in time scale for the diagnosis of acute appendicitis

Acute appendicitis is one of the commonest surgical emergencies received in the surgical ers. the incidence is 1.5 to 1.9 per 1000 population. the diagnosis of acute appendicitis is mainly clinical judgment of the attending clinician. however the efficacy of the diagnosis can be improved and the chances of negative appendectomies can be decreased by following different diagnostic criteria. we worked on alvarado scoring system and found out that the outcome of right diagnosis can be improved by adjusting different variables of the scoring system into time frame. for example the patient presenting in 2-3 hours of acute attack may not have elevated leucocyte counts or even anorexia,similarly the clinical judgment will mainly depend on experience of the clinician. we propose few changes in the alvarodo scoring syetem to make it more diagnosis friendly. the study was conducted in the emergency department by one of the three units at sir ganga ram hospital,lahore. a total number of 190 cases were evaluated during a period of six months. mean age of the patients included in the study was 30.34±9.47 years. mean time of presentation to the er 16.60 ±6.91 hours. 75.8% were suspected of suffering from acute appendicitis by applying alvarado.