ACCURACY FOR DIAGNOSIS OF ACUTE APP ENDICITIS BY RIPASA SCORE AND ALVARADO SCORE.

Background: Acute appendicitis is one of the most common emergency surgical condition. Diagnosis of acute appendicitis mostly use clinical evaluation and some laboratory investigation. There are two clinical scoring system has been used in diagnosis. The Alvarado score is the most popular one but has been reported low accuracy among the Asian population in some studies. Later, RIPASA score has been developed with better accuracy compared to Alvarado score in Asian group. Therefore, this study aimed to compare diagnostic accuracy between Alvarado score and RIPASA score in the Thai population. Materials and Methods: 163 consecutive patients who have clinical suspected of acute appendicitis were included to the study. Both Alvarado score and RIPASA score were applied to all patients prospectively. The histopathology of appendix in case of underwent appendectomy or clinical follow up one month without surgery was been used to analyzed with both scoring systems by cut off 7 for Alvarado score and 7.5 for RIPASA score which indicates a probable for acute appendicitis. Sensitivity, specificity, positive predictive value (PPV), negative predictive value and accuracy of both scoring systems were evaluated. Results: Of 163 patients, 127 underwent appendectomy which 115 patients had histopathological confirmed diagnosis but 12 normal appendixes were reported and 36 patients were observed by clinical. Sensitivity, specificity, NPV, PPV and accuracy of Alvarado score were 83.5%, 62.5%, 61.2%, 84.2% and 80.2% respectively meanwhile they were 92.2%, 50%, 72.8%, 81.5% and 78.6% respectively for RIPASA score (pvalue <0.001 in all modalities). Conclusions: RIPASA score provided more sensitive than Alvarado score but gave less accuracy in diagnosis of acute appendicitis in the Thai population. [ABSTRACT FROM AUTHOR]