Title: Comparison of Efficacy of Ripasa Scoring System with Modified Alvarado Scoring System in Diagnosing Acute Appendicitis
Authors: Ashwin Muthukumar, Junior Sundresh, Gopikrishnan, Badhushah Ibrahim
DOI: https://dx.doi.org/10.18535/jmscr/v5i10.130
Abstract
Background: Acute appendicitis is one of the commonest surgical emergencies. Different scoring systems are postulated to arrive at a diagnosis. A new scoring system named RIPASA scoring system was developed to aid in the diagnosis of acute appendicitis in the Asian countries. We have prospectively compared diagnostic accuracy of RIPASA scoring and modified Alvarado scoring system.
Materials & Methods: This observational study was done in Rajah Muthiah Medical College and Research Institute between June 2015 and August 2016 in patients with clinical diagnosis of acute appendicitis and undergoing appendicectomy were included in the study. After obtaining their consent study were conducted. Both Alvarado score and RIPASA score were calculated for all the patients. The operative findings and postoperative histopathology report were compared with the two scoring systems. Receiver operating curve (ROC), sensitivity, specificity & diagnostic accuracy were calculated.
Results: One hundred and fifty patients satisfying inclusion and exclusion criteria were analysed. At optimal cut-off point of 7.5 derived from ROC curve for RIPASA, the sensitivity & specificity was 99.25% and 55 % respectively. At the cut-off thresh-hold of 7.0 derived from ROC curve for modified Alvarado score the sensitivity and specificity is 78.46% and 59.09% respectively. The diagnostic accuracy of RIPASA was 5.4% better than Modified Alvarado score.
Keywords: Acute Appendicitis, Ripasa Score, Histopathology. ROC Curve, Specificity and Alvarado Scoring System.
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