Comparison of RIPASA and Alvarado score in diagnosing acute appendicitis

Authors

  • Suraj S. Kagwad Department of General Surgery, Sri Venkateshwaraa Medical College Hospital and Research Centre, Puducherry, India http://orcid.org/0000-0002-3648-8664
  • P. Karuppasamy Department of General Surgery, Sri Venkateshwaraa Medical College Hospital and Research Centre, Puducherry, India

DOI:

https://doi.org/10.18203/2349-2902.isj20190550

Keywords:

Alvarado, Acute appendicitis, Asian population, Diagnostic accuracy, Negative appendicectomy, RIPASA score

Abstract

Background: Acute appendicitis is a common cause of abdominal pain and can be difficult to diagnose, especially during its early stages.  The diagnosis of acute appendicitis is based on clinical history, examination combined with investigations. The purpose of this study is to compare between the RIPASA score and Alvarado score in the diagnosis of acute appendicitis. The aim of the present study was to compare the sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of Alvarado and RIPASA score.

Methods: The cases for the study will be sourced from cases admitted in SVMCH and RC, Puducherry during the period of November 2016 to June 2018.

Results: Out of the 144 patients in our study 133 patients were diagnosed with acute appendicitis as per HPE report.

As per our study, sensitivity, specificity, PPV, NPV of RIPASA and Alvarado scoring system is 96.2%, 57.1%, 97.7% and 44.4%; 81.9%,85.7%, 95.1% and 20%  respectively. The diagnostic accuracy of RIPASA score is 94.3 as compared to 82.1 of Alvarado score.

Conclusions: The RIPASA scoring system is a promising and has good sensitivity, specificity and diagnostic accuracy when compared to Alvarado scoring for Asian Population.

RIPASA scoring system is an easy and reliable, cost effective diagnostic tool which reduce negative appendicectomy rates and the expensive radiological investigations for the diagnosis of acute appendicitis.

References

Cuscheri A. The small intestine and vermiform appendix. In: Cuschieri A, Giles GR, Mossa AR, eds. Essential Surgical Practice, 3rd ed. Oxford: Butterworth Heinermann, 1995:1297-1329.

Stephens PL, Mazzucco JJ. Comparison of ultrasound and the Alvarado score for the diagnosis of acute appendicitis. Connecticut Med. 1999 Mar;63(3):137-40.

Kalan M, Talbot D, Cunliffe WJ, Rich AJ. Evaluation of the modified Alvarado score in the diagnosis of acute appendicitis: a prospective study. Ann Roy Coll Surg Eng. 1994 Nov;76(6):418.

Chong CF, Adi MI, Thien A, Suyoi A, Mackie AJ, Tin AS, et al. Development of the RIPASA score: a new appendicitis scoring system for the diagnosis of acute appendicitis. Singapore Med J. 2010 Mar 1;51(3):220.

Fitz RH. Perforating inflatmmation of the vermiform appendix; with special Reference to its early diagnosis and treatment. Am J Med Sci. 1886;92:321-46.

McBurney CH. IV. The incision made in the abdominal wall in cases of appendicitis, with a description of a new method of operating. Ann Surg. 1894 Jul;20(1):38.

Ochsner AJ. A Handbook of Appendicitis, 2nd ed, Chicago: GP Engelhard & Company;1906.

Iqbal J, Khan MH, UlMukim R, Nisar A, Iqbal M. Alvarado score in the diagnosis of acute appendicitis. 2009;25(3);180-4.

Bhabatosh D, Singh G, Sambhaji Kh, Lekshmipriya L, Singh RL, Sharma LK. Comparison between RIPASA and Alvarado score in the Diagnosis of Acute Appendicites. Int J Curr Res. 2016(8);1:25538-546.

Downloads

Published

2019-02-25

Issue

Section

Original Research Articles