A Comparative Study of RIPASA Score and ALVARADO Score in Diagnosis of Acute Appendicitis

Background The RIPASA Score is a new diagnostic scoring system developed for the diagnosis of Acute Appendicitis which showed higher sensitivity, specificity and diagnostic accuracy compared to ALVARADO Score, particularly when applied to Asian population. Here author want to compare prospectively Alvarado and RIPASA score by applying them to the patients attending the hospital with right iliac fossa pain that could probably be acute appendicitis. Methods A prospective analysis of 116 cases admitted with RIF pain during a 2 years period was performed. Patients between 15-60 years were scored as per Alvarado and RIPASA scoring system. Histopathological reports of the cases were collected and compared with the scores. Results The sensitivity of ALVARADO score is estimated to be 52.08 for a cut off of 6. The specificity is 80 %, positive predictive value is 92.59, negative predictive value is 25.81. The Diagnostic accuracy of ALVARADO scoring is found to be 56.9. The sensitivity, specificity, positive predictive value and negative predictive values of RIPASA scoring system are 75 %, 65 %, 91.14 %, 35.14 %. The diagnostic accuracy of RIPASA score is 73.28. Conclusions The difference in the diagnostic accuracy between ALVARADO and RIPASA scoring system is significant indicating that the RIPASA score is a much better diagnostic tool for the diagnosis of acute appendicitis.