Publication:

Superiority of RIPASA over modified ALVARADO scoring systems for the diagnosis of acute appendicitis

Background Acute appendicitis is the most common abdominal emergency. The diagnosis is primarily clinical. Various scores have been established based on clinical, laboratory and radiological investigations for the accurate diagnosis and to reduce the negative appendicectomy rates.

Methods A prospective observational study in the Department of General Surgery was conducted from February 2018 to September 2019. A total of 50 cases were studied. Alvarado and Ripasa scores were calculated and accordingly decision was taken to operate or conserved. Diagnosis was confirmed on histopathological evaluation and the scores were compared on the basis of their sensitivity, specificity, positive predictive value, negative predictive value.

Results RIPASA score is a more valuable tool for diagnosing acute appendicitis with 78.72% sensitivity and specificity 33.33%, in spite of sophisticated investigations like CT, thus reducing the cost of treatment especially in developing countries. In our study. Negative appendicectomy rate was 6% (3 cases out of 50) which is appreciably less than traditional literature.

Conclusions Our study concludes that in the diagnosis of acute appendicitis Ripasa score is more specific than Modified Alvarado score. It helps in categorization for the proper management. It not only reduces the number of "missed appendicitis" but also reduces the cost of treatment by avoiding imaging modalities.