Diagnostic accuracy of ALVARADO score vs RIPASA score in the diagnosis of acute appendicitis

Acute appendicitis: ALVARADO Score VS RIPASA Score

Abstract

BACKGROUND AND OBJECTIVE: In places like Pakistan, which have limited resources, scoring systems are essential. For clinical diagnosis, prompt transfer from primary care institutions, and surgical decision-making when radiography is ambiguous or unavailable, several grading systems can be useful. Therefore, this study will compare RIPASA and Alvarado scores to identify which tool offers better diagnostic reliability in our clinical practice, thereby reducing the risk of complications and negative appendicectomies.

METHODOLOGY: A Cross-sectional (validation) study was Conducted at the Department of Surgery, Combined Military Hospital, Malir, Karachi. A total of 186 patients who had suspected acute appendicitis, underwent appendectomy, and were aged 11 to 69 years of either gender were included. This study excluded patients who had a h/o discomfort lasting longer than five days, were pregnant, had a right iliac fossa mass, experienced persistent recurring pain in the right iliac fossa, or had a h/o pelvic inflammatory disease. After a comprehensive history, examination, and basic laboratory testing, the RIPASA score was established. Suspected cases of acute appendicitis were clinically diagnosed using the Alvarado Score. The histopathological report was compared with the results.

RESULTS: To identify acute appendicitis, the following criteria were used: 89.84% PPV, 86.21% NPV, 79.37% specificity, 93.50% RIPASA score sensitivity, and 88.71% diagnostic accuracy. 89.43%. The diagnostic accuracy for acute appendicitis was 83.87%, with 73.02% specificity, 86.61% PPV, 77.97% NPV, and Alvardo score sensitivity.

CONCLUSION: In contrast to the Alvarado scoring system, this study found that the RIPASA scoring system is a simple, easy, highly sensitive, and accurate method of diagnosing acute appendicitis.