RIPASA Score; Its Sensitivity, Specificity in Diagnosing Suspected Acute Appendicitis

Background: Among acute emergencies, the most commonly occurring one is Acute appendicitis. Scoring systems have beendeveloped such as Alvarado and Modified Alvarado Scores. RIPASA Score has a higher sensitivity in the Asian population set.Thus, came about the plan of our examination to try things out with this new score and to check whether it undoubtedly performswellto the undertaking.Objectives To determine the sensitivity, specificity of the 16-point RIPASA scoring system in diagnosing suspected acuteappendicitis and its validationin correlation with histopathology.Material and Methods: The study was carried out in Khyber Teaching Hospital Peshawar Pakistan from January 2018 to June2018, Department of General Surgery. A total of 322 patients were included in the study. In ED, resident surgeons filled in theRIPASA Score proforma by taking a detailed history and doing a physical examination, and running labs along withultrasonography. The decisionto perform appendectomy was solelytaken bythe senior registrar which was the final decision andthe sample was sent forH/P later on.Results: Of the 322, patients who went through the surgery for acute appendicitis, 188 (58.4%) were male and 134 (41.6%) werefemale, 284(88.2%) had positive histopathology reports and 38 (11.8%) had a negative report. The sensitivity of the RIPASA Scoreat a cut-off value of 8.0 was 97.98%,with the specificity of 77%, and Positive Predictive value of 97.52%,and a Negative PredictiveValue of 86.3%.Conclusion: The clinical implication of RIPASA score is found to be more beneficial than the traditional Alvarado scoring system,thus could bringthe complications rates of appendectomy to significantly lowerfigures.Keywords: Acute Appendicitis,Alvarado Score,RIPASA Score,AsianPopulation, Sensitivity, Specificity