Alvarado or RIPASA score: A diagnostic tool for Acute Appendicitis?

INTRODUCTION: Acute appendicitis is the most common condition encountered in general surgical practice. Alvarado scoring is the commonly used scoring systems for its diagnosis, but its performance has been found to be poor in Asian Population. Hence, we compared the RIPASA scoring system with Alvarado scoring system, to find out which is a better diagnostic tool for acute appendicitis in the Asian population. METHODS: We enrolled 48 patients who presented with RIF pain in the study. Both RIPASA and Alvarado scoring systems were applied to them, but management was carried out as per RIPASA score. Final diagnosis was confirmed either by post-operative HPE report. Final diagnosis was analysed against both RIPASA and Alvarado scoring systems. Sensitivity, Specificity, Positive PredictiveValue, Negative Predictive Value and Diagnostic Accuracy was calculated for both RIPASA and Alvarado scoring systems. RESULTS: It was found that RIPASA was better than Alvarado scoring system in terms of Specificity (67% v/s 50%) and Positive Predictive Value (95% v/s 93%), and also to some extent in terms of Diagnostic Accuracy (96% v/s 93%). Whereas the Sensitivity (100% in both) and Negative Predictive Value (100%) were similar in both. CONCLUSION: RIPASA is a more specific and accurate scoring system in our asian population, when compared to Alvarado scoring system. It reduces the number of missed appendicitis cases. [ABSTRACT FROM AUTHOR]