COMPARING RIPASA SCORE AND ALVARADO SCORE IN AN ACCURATE DIAGNOSIS OF ACUTE APPENDICITIS

Authors

  • Shehryar Noor Accident and Emergency Department, Khyber Teaching Hospital
  • Abdul Wahab Surgical B Unit, Lady Reading Hospital Peshawar
  • Gulsharif Afridi Surgical D Unit, Lady Reading Hospital Peshawar
  • Kaleem Ullah Surgical A Unit, Khyber Teaching Hospital Peshawar.

Abstract

Background: The clinical diagnosis of acute appendicitis remains difficult despite the use of different scoring systems. A high rate of negative appendectomies is no longer acceptable. This study was aimed to compare RIPASA score and Alvarado score in Pakistani population for the diagnosis of acute appendicitis using histopathology as a gold standard. Methods: This cross-sectional prospective study was carried out from January to September 2018 in the Accident and Emergency Department and Department of Surgery, Khyber Teaching Hospital, Peshawar. Patients clinically suspected as acute appendicitis aided by routine ultrasound were included in the study. RIPASA and Alvarado scoring was done in all patients. After appendectomies, specimen was sent for histopathological examination. A score of 7.5 was considered as optimal cutoff threshold for RIPASA and 7 for Alvarado score. Sensitivity, Specificity, Positive Predictive Value (PPV), Negative Predictive Value (NPV) and accuracies of both scores were calculated. Results: A total of 300 patients were included in the study. The mean age of patients was 28±10.0 years and there were 176 males. Sensitivity, Specificity of RIPASA score and Alvarado score was found to be 98.52% and 90%, and 68.15% and 80% respectively. Positive Predictive Value and NPV of RIPASA score was 98.88% and 97.67% as compared to 96.84% and 21.82% for Alvarado score. Diagnostic accuracy of RIPASA and Alvarado score was 97.67% and 69.33% respectively. Conclusion: RIPASA scoring system is a more accurate, sensitive and specific indicator of diagnosing acute appendicitis as compared to Alvarado scoring systemKeywords: RIPASA; Alvarado; Acute Appendicitis

Author Biographies

Shehryar Noor, Accident and Emergency Department, Khyber Teaching Hospital

Consultant surgery and Incharge Accident and Emergency Department Khyber Teaching Hospital Peshawar.03005844137House No. 129, Street 5, Askari 6, Nasir Bagh road Peshawar.

Abdul Wahab, Surgical B Unit, Lady Reading Hospital Peshawar

Assistant Professor Surgical B UnitLady reading hospital Peshawar03459050066House No. 187, Street 5, Sector J2, Phase 2 Hayatabad Peshawar

Gulsharif Afridi, Surgical D Unit, Lady Reading Hospital Peshawar

Assistant Professor Surgical D UnitLady Reading Hospital Peshawar.03005959004New TMO Hostel Room No. B 13 Lady reading hospital Peshawar

Kaleem Ullah, Surgical A Unit, Khyber Teaching Hospital Peshawar.

Registrar Surgical A wardKhyber teaching Hospital Peshawar.03459451961Room No. 58 New doctors hostel KTH Peshawar.

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Published

2020-01-23

Issue

Vol. 32 No. 1 (2020): JOURNAL OF AYUB MEDICAL COLLEGE, ABBOTTABAD

Section

ORIGINAL ARTICLE

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