A Comparative Study of Ripasa and Alvarado Score in the Diagnosis of Acute Appendicitis

Background: 1,2 The most common scoring system used worldwide for acute appendicitis is Alvarado score . But recent 3 4 studies have shown that it has less diagnostic accuracy in Asian and Middle Eastern population ' . The Raja Isteri Pengirm Anak Saleha Appendicitis (RIPASA) score is more extensive than the Alvarado score with certain parameters like age, gender and duration of 5 symptoms prior to the presentation. So, comparison of Alvarado and RIPASA scoring system is carried out in a tertiary teaching hospital, to find out better scoring system in the Indian population. The objective of the study is comparison of Alv Objective: arado and RIPASA scoring system to find out better scoring system in Indian population. 144 patients presenting to surgical outpatie Methods: nt department and emergency department with appendicitis were included. Results: RIPASA score when applied on study population, 94% of patients who actually had acute appendicitis were correctly diagnosed compared to Alvarado score having correct diagnostic percentage as 86%. In low probability group patients, 66.7% patients were not having appendicitis in RIPASA score whereas only 39.3 % patients in Alvarado scoring system. Conclusion: Specificity of RIPASA score was 72.7 % whereas of Alvarado score was 50%, which is statistically significant. NPV of RIPASA score was 66.7%, whereas of Alvarado was 39.3% which is statistically significant. Diagnostic accuracy of RIPASA Score is 90.3% whereas of Alvarado score is 80% which has almost of 10% difference.