Comparison between RIPASA and ALVARADO scoring in diagnosing acute appendicitis

BACKGROUND AND OBJECTIVE: Acute appendicitis is one of the most common cause of acute abdominal pain and emergency appendicectomy is the most common emergency surgery. The confirmed diagnosis of appendicitis is by histopathological examination which is not possible before appendicectomy. Also the rate of negative exploration remains high in the rate of 15-30%. Scoring systems based on history , clinical examination and basic investigations are there in aiding the diagnosis of acute appendicitis and decreasing negative exploration. This study compares RIPASA and Alvarado scoring systems in diagnosing acute appendicitis. METHODS: A comparative study was done between November 2015 to June 2015. Patients diagnosed as acute appendicitis in department of General Surgery, Govt. Royapettah Hospital. 100 of them are to be selected on the basis of non probability (purposive) sampling method. After considering the inclusion and exclusion criteria 96 were enrolled into the study. A full history, clinical examination and both scoring systems were done on the patients. RESULTS: Out of the 96 patients 46 patients (48%) were male and 50 patients (52%) were female.65 patients underwent emergency appendicectomy based on the clinical decision of a senior surgeon. The sensitivity and specificity of the RIPASA scoring system was 98.0% and 80.43% respectively. The sensitivity and specificity of the Alvarado scoring system was 80.43% and 86.95% respectively. The PPV of RIPASA and ALVARADO was 84% and 85% respectively. The NPP of RIPASA and ALVARADO was 97% and 71% respectively. The Diagnostic Accuracy was 89% for RIPASA and 77% for Alvarado. The Sensitivity, NPV, and Diagnostic accuracy of RIPASA scoring was significantly higher than the Alvarado scoring. (p