Validity of RIPASA scoring system as a diagnostic tool of acute appendicitis in comparison with Alvarado scoring system in the Arab population

Abstract

Background: RIPASA scoring has been developed to replace the disappointingly low accuracy Alvarado score in Asian population for diagnosis of acute appendicitis. Objective of present study was to compare the RIPASA and Alvarado score in Arab population and determine their accuracy when applied to our patients in Egypt and Kingdom of Saudi Arabia (KSA).Methods: By applying the RIPASA and Alvarado scores to 100 patients from KSA, 100 patients from Egypt who presented to emergency with right iliac fossa pain. The decisions for appendicectomy were based on clinical judgment only. Histopathology as gold standard was correlated with both scores. ROC curve analysis, sensitivity, specificity, positive predictive value and negative predictive value, diagnostic accuracy for RIPASA and Alvarado system were calculated using SPSS version 20.Results: On comparing both the scoring system in patients of both hospital groups, we found that sensitivity of RIPASA scoring is greater than Alvarado scoring system 95.51% and 73.03% respectively in BTH group, and 97.56% and 79.27% respectively in KASH group, while the specificity of RIPASA scoring system is less than Alvarado scoring system 72.73% and 81.82% respectively in BTH group and 66.67% and 83.33% respectively in KASH group.Conclusions: In our Arab population the RIPASA score could be applied in diagnosis of acute appendicitis with higher sensitivity, NPV and diagnostic accuracy compared to the Alvarado score.

Accuracy and Sensitivity of RIPASA Score in Diagnosis of Acute Appendicitis

“…Nevertheless, this was lower than the 97.4% reported by Subramani et al [26] , and it is thought that this is because there were a lot truer negative instances recorded in their study compared to the sample size. Numerous researches [27] had shown that the RIPASA score's accuracy fell between 90.5% and 97.5%, which was comparable to the RIPASA's 94.8% claimed diagnostic accuracy in the current study. Although the current results were significantly higher than those of Pasumarthi et al [28] and Chae et al [23], this could be because many patients with urological symptoms were included in the study, which resulted in a significant number of false positive instances.…”

A Comparison of the Modified Alvarado Score and the Raja Isteri Pengiran Anak Saleha Appendicitis (Ripasa) Score in a Southeast Asian Population With Histopathology as the Gold Standard

“…Studies from Jordan, Kuwait, Iran, and Turkey as well as a multicenter, cross-border study between Saudi Arabia and Egypt corroborated the results of the original study in the Middle Eastern population as well [17][18][19][20][21].…”

Association Between Raja Isteri Pengiran Anak Saleha Appendicitis (RIPASA) Scoring and Pathological Severity of Acute Appendicitis: A Cross-Sectional Study

“…Another investigation conducted in India demonstrated that the MASS had an SN of 64.44% and an SP of 58.82%, whereas the RIPASA score had an SN of 87.78% and an SP of 76.47% [22]. Research conducted in Jordan [23], Kuwait [21], Iran [24], and Turkey [5], together with a multicenter, cross-border study involving Saudi Arabia and Egypt [25], have confirmed the findings of the initial study in the Middle Eastern population. Malik et al conducted one of the initial assessments of the RIPASA scoring in a Western population in Ireland, following the observation of favorable outcomes in several Eastern investigations [26].…”