Raja Isteri Pengiran Anak Saleha appendicitis and Alvarado scores in diagnosis of patients with acute appendicitis

Abstract

Objective The aim was to compare between Raja Isteri Pengiran Anak Saleha appendicitis (RIPASA) and Alvarado scoring systems in the diagnosis of acute appendicitis. Background Acute appendicitis is one of the most common surgical emergencies. The RIPASA and Alvarado scores are new diagnostic scoring systems developed for the diagnosis of acute appendicitis. Patients and methods A cross-sectional study was carried out on 186 patients complaining of acute abdominal pain during the 8-month period in the Department of Surgery, Menoufia University and Tala Control Hospital. Histopathological reports of the cases were collected and compared with the scores. Full history was taken, and routine investigation was done. Results There was poor agreement between Alvarado and RIPASA scoring systems in the diagnosis of appendicitis. The agreement in appendicitis was 43%. Moreover, RIPSA score diagnosis and histopathological diagnosis were not significantly different among the studied patients. However, there was a significant difference between RIPSA score and histopathological diagnosis in the diagnosis of appendicitis among patients. Regarding accuracy of diagnosis, RIPSA score had a sensitive level (94%) higher than Alvarado score (54%) in diagnosis of appendicitis, whereas Alvarado score had specificity level (62%) higher than RIPSA score (10%). Conclusion The difference in the diagnostic accuracy between Alvarado and RIPASA scoring system is significant, indicating that the RIPASA score is a much better diagnostic tool for the diagnosis of acute appendicitis.