Diagnostic Accuracy of the RIPASA Score in Suspected Acute Appendicitis in Adults: A Cross-sectional Study Comparing it with Histopathological Findings from Bagalkot, India

Abstract

Introduction: Acute appendicitis remains the most commonly occurring surgical emergency, with a prevalence rate of approximately 8% among individuals aged 10-30 years. The Raja Isteri Pengiran Anak Saleha for Appendicitis (RIPASA) scoring system appears to be an accurate, simple, and rapid parameter for predicting Acute Appendicitis (AA). Aim: To determine the validity and diagnostic efficiency of the RIPASA scoring system for acute appendicitis and compare it with histopathology. Materials and Methods: A cross-sectional study was conducted on patients admitted to Nijalingappa Medical College in Bagalkot, Karnataka, India, from January 2020 to June 2021. The study included patients of both genders above 18 years of age, presenting with right iliac fossa pain. Detailed history was obtained, and a thorough clinical examination was performed. Appropriate investigations were conducted, and the RIPASA score was calculated. Qualitative data were represented as frequency and percentage. Sensitivity, specificity, positive predictive values (PPV), negative predictive values (NPV), and diagnostic accuracy were calculated to assess the validity of the tool. An ROC curve was plotted to determine the area under the curve. Results: A total of 90 patients had RIPASA scores of ≥7.5, and the majority of them (75.6%) were under the age of 40 years, with a mean age of 39.9 years. The male-to-female ratio was 48.9:51.1, approximately 0.95. The sensitivity, specificity, and diagnostic accuracy of the RIPASA scoring system were 82%, 100%, and 82%, respectively. Conclusion: The RIPASA scoring system demonstrates good applicability and efficiency in diagnosing acute appendicitis. It is easily accessible and non-invasive, thereby reducing the cost of radiological investigations and unnecessary economic burden.