Comparative Study of Raja Isteri Pengiran Anak Saleha Appendicitis Scoring System and Alvarado Scoring System for Clinical Diagnosis of Acute Appendicitis

Abstract

Introduction: Acute appendicitis is essentially a clinical diagnosis, and there are many places in India where confirmation based on radiological imaging is not available immediately. In such scenarios, clinical scoring system comes handy. Materials and Methods: This paper is based on a study to compare the sensitivity and specificity of Raja Isteri Pengiran Anak Saleha Appendicitis (RIPASA) Scoring System and Alvarado Scoring System in the clinical diagnosis of acute appendicitis. There is very little literature about RIPASA Scoring System. Results: The Alvarado Scoring System showed that 6%–12.5% of patients had total score of 5–6 (possible), 31%–64.6% had total score of 7–8 (probable) and 11%–22.9% had total score of 9–10 (very probable). Forty-two patients had a total score of ≥7, which is the cut-off score to be considered for confirming appendicitis. RIPASA Scoring System showed that 43%–89.6% of patients had cut-off score >7.5 (suggestive of appendicitis) and only 5%–10.4% of patients had score <7.5 (other causes). Conclusions: RIPASA Scoring System was more sensitive and specific than Alvarado Scoring System in the clinical diagnosis of acute appendicitis.