Evaluation of Alvarado Score and RIPASA Score in the Diagnosis of Acute Appendicitis

Abstract

Original Research ArticleBackground: Acute appendicitis despite being a common problem, remains a difficult diagnosis to establish. A delay to diagnose this condition as well as negative appendicectomies should be prevented. The above problems can be avoided by using scoring systems. This study aims to compare the efficacy of Alvarado score and Raja Isteri Pengiran Anak Saleha Appendicitis (RIPASA) score in the diagnosis of acute appendicitis. Methods: This is a prospective observational study attempted to compare the efficiency of Alvarado and RIPASA score, in pre-operative diagnosis of acute appendicitis and to correlate these scores with histo-pathological diagnosis. 100 cases satisfying inclusion and exclusion criteria were selected for study. Based on detailed history and thorough clinical examination, diagnosis of acute appendicitis was made. Results: The sensitivity and specificity of RIPASA score were 97.4% and 56.52% respectively and Alvarado score were 70.12% and 78.26% respectively. The accuracy for diagnosing the acute appendicitis showed high probability with RIPASA score (88%) when compared to Alvarado score (72%). Conclusion:The RIPASA scoring system had a higher sensitivity, Negative Predictive Value and accuracy, than the Alvarado score in the diagnosis of Acute Appendicitis. Hence, the new appendicitis scoring system 'RIPASA' score is simple, promising and has good diagnostic accuracy.