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

N. Nanjundaiah, Ashfaque Mohammed, Venkatesh Shanbhag

Research output: Contribution to journalArticle

21 Citations (Scopus)

Abstract

Background: Acute appendicitis is one of the most common surgical emergencies. Different techniques have been devised to assist in equivocal cases in attempts to decrease negative appendicectomy rates. A number of scoring systems have been used for aiding in early diagnosis of acute appendicitis and its prompt management of which Alvarado score is the most popular. The accuracy of Alvarado score in the diagnosis of acute appendicitis is disappointingly low in Asian population. And RIPASA scoring has been designed for the diagnosis of acute appendicitis in the Asian population. So we prospectively applied and compared Alvarado and RIPASA score in the diagnosis of acute appendicitis in Indian population.

Materials and Methods: We compared prospectively RIPASA and Alvarado scoring system by applying them to 206 patients. Both scores were calculated for patients who presented with right iliac fossa pain during the study period. Depending on clinical judgment appendicectomy was done. Post operative histopathology report was correlated with the scores. A score of 7.5 is the optimal cut off threshold for RIPASA and 7 for Alvarado scoring system. Sensitivity, specificity, positive predictive value (PPV) and negative predictive (NPV) for RIPASA & Alvarado system was done.

Results: The sensitivity and specificity of RIPASA score were 96.2% and 90.5% respectively. The sensitivity and specificity of Alvarado score were 58.9% and 85.7% respectively. RIPASA score correctly classified 96 percent of all patients confirmed with histological acute appendicitis to the high probability group (RIPASA score greater than 7.5)compared with 58.9% with Alvarado score (Alvarado score greater than 7.0; p-value less than 0.001).

Conclusion: RIPASA scoring system is more convenient, accurate, and specific scoring system for Indian population than Alvarado scoring system.

Original languageEnglish
Pages (from-to)NC03-NC05
JournalJournal of Clinical and Diagnostic Research
Volume8
Issue number11
DOIs
Publication statusPublished - 20-11-2014

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Appendicitis
Sensitivity and Specificity
Population
Early Diagnosis
Emergencies
Pain

All Science Journal Classification (ASJC) codes

  • Medicine(all)
  • Clinical Biochemistry

Cite this

Nanjundaiah, N. ; Mohammed, Ashfaque ; Shanbhag, Venkatesh. / A comparative study of RIPASA score and ALVARADO score in the diagnosis of acute appendicitis. In: Journal of Clinical and Diagnostic Research. 2014 ; Vol. 8, No. 11. pp. NC03-NC05.
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abstract = "Background: Acute appendicitis is one of the most common surgical emergencies. Different techniques have been devised to assist in equivocal cases in attempts to decrease negative appendicectomy rates. A number of scoring systems have been used for aiding in early diagnosis of acute appendicitis and its prompt management of which Alvarado score is the most popular. The accuracy of Alvarado score in the diagnosis of acute appendicitis is disappointingly low in Asian population. And RIPASA scoring has been designed for the diagnosis of acute appendicitis in the Asian population. So we prospectively applied and compared Alvarado and RIPASA score in the diagnosis of acute appendicitis in Indian population.Materials and Methods: We compared prospectively RIPASA and Alvarado scoring system by applying them to 206 patients. Both scores were calculated for patients who presented with right iliac fossa pain during the study period. Depending on clinical judgment appendicectomy was done. Post operative histopathology report was correlated with the scores. A score of 7.5 is the optimal cut off threshold for RIPASA and 7 for Alvarado scoring system. Sensitivity, specificity, positive predictive value (PPV) and negative predictive (NPV) for RIPASA & Alvarado system was done.Results: The sensitivity and specificity of RIPASA score were 96.2{\%} and 90.5{\%} respectively. The sensitivity and specificity of Alvarado score were 58.9{\%} and 85.7{\%} respectively. RIPASA score correctly classified 96 percent of all patients confirmed with histological acute appendicitis to the high probability group (RIPASA score greater than 7.5)compared with 58.9{\%} with Alvarado score (Alvarado score greater than 7.0; p-value less than 0.001).Conclusion: RIPASA scoring system is more convenient, accurate, and specific scoring system for Indian population than Alvarado scoring system.",
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A comparative study of RIPASA score and ALVARADO score in the diagnosis of acute appendicitis. / Nanjundaiah, N.; Mohammed, Ashfaque; Shanbhag, Venkatesh.

In: Journal of Clinical and Diagnostic Research, Vol. 8, No. 11, 20.11.2014, p. NC03-NC05.

Research output: Contribution to journalArticle

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T1 - A comparative study of RIPASA score and ALVARADO score in the diagnosis of acute appendicitis

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AU - Mohammed, Ashfaque

AU - Shanbhag, Venkatesh

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N2 - Background: Acute appendicitis is one of the most common surgical emergencies. Different techniques have been devised to assist in equivocal cases in attempts to decrease negative appendicectomy rates. A number of scoring systems have been used for aiding in early diagnosis of acute appendicitis and its prompt management of which Alvarado score is the most popular. The accuracy of Alvarado score in the diagnosis of acute appendicitis is disappointingly low in Asian population. And RIPASA scoring has been designed for the diagnosis of acute appendicitis in the Asian population. So we prospectively applied and compared Alvarado and RIPASA score in the diagnosis of acute appendicitis in Indian population.Materials and Methods: We compared prospectively RIPASA and Alvarado scoring system by applying them to 206 patients. Both scores were calculated for patients who presented with right iliac fossa pain during the study period. Depending on clinical judgment appendicectomy was done. Post operative histopathology report was correlated with the scores. A score of 7.5 is the optimal cut off threshold for RIPASA and 7 for Alvarado scoring system. Sensitivity, specificity, positive predictive value (PPV) and negative predictive (NPV) for RIPASA & Alvarado system was done.Results: The sensitivity and specificity of RIPASA score were 96.2% and 90.5% respectively. The sensitivity and specificity of Alvarado score were 58.9% and 85.7% respectively. RIPASA score correctly classified 96 percent of all patients confirmed with histological acute appendicitis to the high probability group (RIPASA score greater than 7.5)compared with 58.9% with Alvarado score (Alvarado score greater than 7.0; p-value less than 0.001).Conclusion: RIPASA scoring system is more convenient, accurate, and specific scoring system for Indian population than Alvarado scoring system.

AB - Background: Acute appendicitis is one of the most common surgical emergencies. Different techniques have been devised to assist in equivocal cases in attempts to decrease negative appendicectomy rates. A number of scoring systems have been used for aiding in early diagnosis of acute appendicitis and its prompt management of which Alvarado score is the most popular. The accuracy of Alvarado score in the diagnosis of acute appendicitis is disappointingly low in Asian population. And RIPASA scoring has been designed for the diagnosis of acute appendicitis in the Asian population. So we prospectively applied and compared Alvarado and RIPASA score in the diagnosis of acute appendicitis in Indian population.Materials and Methods: We compared prospectively RIPASA and Alvarado scoring system by applying them to 206 patients. Both scores were calculated for patients who presented with right iliac fossa pain during the study period. Depending on clinical judgment appendicectomy was done. Post operative histopathology report was correlated with the scores. A score of 7.5 is the optimal cut off threshold for RIPASA and 7 for Alvarado scoring system. Sensitivity, specificity, positive predictive value (PPV) and negative predictive (NPV) for RIPASA & Alvarado system was done.Results: The sensitivity and specificity of RIPASA score were 96.2% and 90.5% respectively. The sensitivity and specificity of Alvarado score were 58.9% and 85.7% respectively. RIPASA score correctly classified 96 percent of all patients confirmed with histological acute appendicitis to the high probability group (RIPASA score greater than 7.5)compared with 58.9% with Alvarado score (Alvarado score greater than 7.0; p-value less than 0.001).Conclusion: RIPASA scoring system is more convenient, accurate, and specific scoring system for Indian population than Alvarado scoring system.

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