Study on RIPASA Scoring in Clinical Diagnosis of Acute Appendicitis

Dr. Prashant Mukadam, Dr. Vineet Shukla, Dr. Virinchi Dabbir, Dr. Dip Joshi

Abstract: Background: The RIPASA Score is a new diagnostic scoring system developed for the diagnosis of Acute Appendicitis which showed higher sensitivity, specificity and diagnostic accuracy compared to other scoring systems, particularly when applied to Asian population [1]. Here author wants to study RIPASA score by applying them to the patients attending the hospital with right iliac fossa pain that could probably be acute appendicitis. Methods: A prospective analysis of 100 cases admitted with RIF pain during a 2 years period was performed. Patients between 15-60 years were scored as per Alvarado and RIPASA scoring system. Histopathological reports of the cases were collected and compared with the scores. Results: The sensitivity of ALVARADO score is estimated to be 73 % for a cut off of 6. The specificity is 78 %, positive predictive value is 92, negative predictive value is 35. The Diagnostic accuracy of ALVARADO scoring is found to be 74 %. The sensitivity, specificity, positive predictive value and negative predictive values of RIPASA scoring system in our study are 95.5 %, 84.9 %, 92.5 %, 90.3 %. The diagnostic accuracy of RIPASA score is 92 %. Conclusions: The difference in the diagnostic accuracy between ALVARADO and RIPASA scoring system is significant indicating that the RIPASA score is a much better diagnostic tool for the diagnosis

Keywords: Acute appendicitis, ALVARADO score, Diagnostic accuracy, Histopathology, RIPASA score