Validation of Ripasa Score in Diagnosis of Suspected Acute Appendicitis

Abstract

Background: To assess validation of RIPASA score in diagnosis of suspected acute appendicitis. Subjects and Methods: One hundred ten cases of acute appendicitis of both genders were selected. Parameters such as RIF tenderness, RIF guarding, rebound tenderness, Rovsings sign and fever was recorded. The RIPASA score was computed as per guidelines. RIPASA score of <7.5 was considered as cut off to label a person as high or low probability of appendicitis. Results: Baseline characteristics comprised of anorexia in 90%, right iliac fossa pain in 96%, migration of pain in 84%, fever in 87%, nausea and vomiting in 92%, RIF tenderness in 85%, rebound tenderness in 80%, guarding in 37%, Rovsings Sign in 43%, duration of symptoms <48 hours was seen in 52%, duration of symptoms >48 hours was seen in 48%, negative urine analysis in 96%, positive histopathology in 91% and positive ultrasound sonography in 92%. A non- significant difference was observed (P> 0.05). Sensitivity of RIPASA score was 97.4% and ultrasound was 94%, specificity of RIPASA score was 67.5% and ultrasound was 67.2%, positive predictive value of RIPASA score was 97.2% and ultrasound was 97.2% and negative predictive value of RIPASA score was 66.8% and ultrasound was 52.4% [Table 3]. Conclusion: RIPASA score can be considered as a useful tool in making clinical decisions. The RIPASA appendicitis scoring system is a promising tool in detecting appendicitis.