A comparative study of RIPASA score and ALVARADO score in diagnosis of acute appendicitis

Pasumarthi, Vamsavardhan; Madhu, C P

doi:10.18203/2349-2902.isj20180430

Cited by 16 publications

(27 citation statements)

References 5 publications

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“…The diagnostic accuracy for the scores was better in favour of the RIPASA group with a difference of 16,38%, p<0,001. 13 Only the NPV for Alvarado score does not resemble our results and is different then the literature also.…”

Section: Discussioncontrasting

confidence: 99%

Compari̇son of Alvarado and Ripasa Scores i̇n Pati̇ents Wi̇th Acute Appendi̇ci̇ti̇s

Gökçe

Korkmaz

Tekin

et al. 2020

Cumhuriyet Medical Journal

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Acute appendicitis management delays results in perforation and increases the morbidity and mortality. Studies have reported a 20% perforation rate, and 2-30% negative laparotomy whose diagnoses are made by symptoms and physical examination. By using anamnesis, clinical signssymptoms and inflammatory parameters to reduce the diagnosis time, complications, and morbidity-mortality of AA, various scoring methods have been developed. The first scoring system defined for this purpose is Alvarado scoring system. The RIPASA scoring system was developed for patients in Asia. In this study, we aimed to determine which scoring is more suitable for our population by comparing Alvarado and RIPASA scoring methods in patients who underwent an appendectomy. Method: The Alvarado and RIPASA scores of each patient were calculated by the scoring system parameters after the 182 patient files were analyzed retrospectively. At cut-off value of 7.5 for RIPASA score and 7 for Alvarado score, patients were divided into high and low-risk groups. The positive predictive value, negative predictive value, sensitivity, and specificity were calculated and the two scoring systems' effectivity were compared with Chisquare and area under curve analysis. Results: According to the histological examination 42(23%) patients were not considered as acute appendicitis. RİPASA scoring systems high-risk group classification was better by predicting the acute appendicitis patients (p = 0.001, p <0.05). The area under the curve for RIPASA score calculated as 0.738 and this is statistically significant (p = 0.001; p <0.05). The result was better then the Alvarado AUC score (0,633). Alvarado scoring systems' negative predictive value was higher than the RİPASA score, respectively (58,14%, 32.56%). Conclusions: It is beneficial to use the RIPASA scoring system for patients in our region to reduce the rate of negative laparotomy and unnecessary surgical procedures in patients admitted to emergency services with the suspicion of acute appendicitis.

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Section: Discussioncontrasting

confidence: 99%

Compari̇son of Alvarado and Ripasa Scores i̇n Pati̇ents Wi̇th Acute Appendi̇ci̇ti̇s

Gökçe

Korkmaz

Tekin

et al. 2020

Cumhuriyet Medical Journal

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“…The comparison of diagnostic accuracy of modified Alvarado and RIPASA Score across various studies is being tabulated below (Table 4 & 5). In a similar study by Pasumarthi V [15] , both scores showed good efficacy in screening the cases appendicitis with overall screening efficacy of RIPASA score was better (AUC -0.810 vs 0.77). In a study done by Chong CF et al [19] , area under curve for the RIPASA score is 0.9183 which is greater than that for the Alvarado score, which is 0.8651.…”

Section: Discussionmentioning

confidence: 68%

“…These parameters are shown to affect the sensitivity and specificity of Alvarado scoring system in the diagnosis of acute appendicitis [13] . The RIPASA Score is a new diagnostic scoring system developed for the diagnosis of Acute Appendicitis and has been shown to have significantly higher sensitivity, specificity and diagnostic accuracy compared to Alvarado Score, particularly when applied to Asian population [14][15][16][17][18][19] . Not many studies in India have been conducted to compare RIPASA and Alvarado scoring system in the diagnosis of acute appendicitis.…”

Section: Introductionmentioning

confidence: 99%

Acute appendicitis: Diagnostic accuracy of Alvarado and RIPASA scoring system

Sharma¹,

Bambora²,

Barkesiya³

2020

Int. J. Surg. Sci.

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Introduction: One of the commonest clinical presentation that requires emergency surgery is acute appendicitis. Much efforts have been directed towards early diagnosis and intervention. Delay in diagnosis leads to increase morbidity and costs. In present study, we aimed to compared two scores i.e. RIPASA and Alvarado scoring system in the diagnosis of acute appendicitis. Materials and methods: Present hospital based screening included 100 patients presenting with Right iliac fossa pain and clinically diagnosed as acute appendicitis. The diagnosis of acute appendicitis was confirmed by operative findings and histopathological assessment of the appendicectomy specimen. A score of 7 or above is taken as high probability of acute appendicitis for Alvarado scoring system while a score of 7.5 or above was taken as high probability of acute appendicitis for RIPASA scoring system. Results: Sensitivity and specificity of modified Alvarado score in diagnosing Appendicitis was 58.7% and 88% while PPV and NPV was 93.6% and 41.5%. Sensitivity and specificity of RIPASA score in diagnosing Appendicitis was 89.3% and 84% while PPV and NPV was 94.4% and 72.4%. Overall diagnostic accuracy was 88% and 66% for RIPASA and modified Alvarado Score. Both scores showed good efficacy in screening the cases appendicitis on ROC analysis. However, overall screening efficacy of RIPASA score was better than Modified Alvarado Score (AUC -0.891 vs 0.702). Conclusion:RIPASA score is currently a much better diagnostic scoring system for acute appendicitis compared to the Alvarado score. RIPASA had significantly higher sensitivity, NPV and diagnostic accuracy in our study group. The 14 fixed parameters can be easily and rapidly obtained in any population setting by taking a complete history and conducting a clinical examination and two simple investigations. In remote settings or emergency, a quick decision can be made with regards to referral to an operating surgeon or observation. The use of RIPASA scoring would help in decreasing the unwarranted patient admissions and also expensive radiological investigations.

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“…In another study conducted by Pasumarthi V et al 19 reported that RIPASA scoring system is more useful tool for acute appendicitis as compared to Alvarado scoring system. He reported sensitivity and specificity of Alvarado as 52.08% and 80% respectively and diagnostic accuracy was 56.9%.…”

Section: Discussionmentioning

confidence: 98%

Evaluation of Ripasa scoring system for diagnosis of acute appendicitis.

Anwer

Ahmed

Rehman

2020

TPMJ

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Objectives: To evaluate the role of RIPASA scoring system for diagnosis of acute appendicitis taking histopathology as gold standard. Study Design: Prospective Study. Setting: Department of General Surgery, Nishter Hospital Multan. Period: February 2016 to February 2017. Material & Methods: One hundred and sixty 160 patients were included in this study. Study was started after ethical approval from ethical board of institution and informed consent from patients was taken. Non probability consecutive sampling was used. Main outcome variables were sensitivity, specificity and diagnostic accuracy of RIPASA score. SPSS version was used to analyze data. P value ≤ 0.05 was considered as significant. Results: Estimated sensitivity was 97.9%, which means that of the patients with acute appendicitis, 97.9% were diagnosed correctly. The estimated specificity was 76.9%, which means that of the patients not having acute appendicitis, 76.9% were diagnosed correctly. Positive predictive value was 86.1% and negative predictive value was 96.2%. The overall accuracy was 89.4% for diagnosing acute appendicitis. Conclusion: RIPASA scoring system is efficient, reliable and more diagnostic in cases of acute appendicitis. Abdominal ultrasonography is not suitable diagnostic tool to rule out negative appendectomy.

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A comparative study of RIPASA score and ALVARADO score in diagnosis of acute appendicitis

Cited by 16 publications

References 5 publications

Compari̇son of Alvarado and Ripasa Scores i̇n Pati̇ents Wi̇th Acute Appendi̇ci̇ti̇s

Compari̇son of Alvarado and Ripasa Scores i̇n Pati̇ents Wi̇th Acute Appendi̇ci̇ti̇s

Acute appendicitis: Diagnostic accuracy of Alvarado and RIPASA scoring system

Evaluation of Ripasa scoring system for diagnosis of acute appendicitis.

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