scholarly journals Correlation of Ultrasound and RIPASA Scoring System in the Diagnosis of Acute Appendicitis

2018 ◽  
Vol 5 ◽  
Author(s):  
Anand Rai Bansal ◽  
Suvendu Sekhar Jena ◽  
Sanjeev Kumar
Keyword(s):  
Acute Appendicitis ◽  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Study Design ◽  
Predictive Value ◽  
Scoring System ◽  
Negative Appendicectomy ◽  
Low Sensitivity ◽  
Sensitivity Specificity

Objective: Correlation of Ultrasound and RIPASA scoring system in the diagnosis of acute appendicitis. Study Design: 50 patients presenting to emergency underwent ultrasound and evaluation as per RIPASA scoring system followed by emergency appendicectomy. The sensitivity, specificity, positive and negative predictive value calculated for each goups. Results: The sensitivity, specificity, Positive Predictive Value and Negative Predictive Value for ultrasound were 75.51%, 100%, 100% and 7.69% respectively and that for RIPASA scoring system were 93.9%, 100% 100% and 25% respectively. The negative appendicectomy rate was 2%. Conclusion: RIPASA scoring system may be used for correctly diagnosing acute appendicitis but low sensitivity of ultrasound precludes its routine use and may be used as a complementary tool in diagnosing acute appendicitis. Keywards: Acute Appendictis, RIPASA, Ultrasound.

scholarly journals Correlation of Ultrasound and RIPASA Scoring System in the Diagnosis of Acute Appendicitis

2018 ◽  
Vol 5 (r) ◽  
Author(s):  
Anand Rai BANSAL ◽  
Suvendu Sekhar JENA ◽  
Sanjeev KUMAR
Keyword(s):  
Acute Appendicitis ◽  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Study Design ◽  
Predictive Value ◽  
Scoring System ◽  
Negative Appendicectomy ◽  
Low Sensitivity ◽  
Sensitivity Specificity

Objective: Correlation of Ultrasound and RIPASA scoring system in the diagnosis of acute appendicitis. Study Design: 50 patients presenting to emergency underwent ultrasound and evaluation as per RIPASA scoring system followed by emergency appendicectomy. The sensitivity, specificity, positive and negative predictive value calculated for each goups. Results: The sensitivity, specificity, Positive Predictive Value and Negative Predictive Value for ultrasound were 75.51%, 100%, 100% and 7.69% respectively and that for RIPASA scoring system were 93.9%, 100% 100% and 25% respectively. The negative appendicectomy rate was 2%. Conclusion: RIPASA scoring system may be used for correctly diagnosing acute appendicitis but low sensitivity of ultrasound precludes its routine use and may be used as a complementary tool in diagnosing acute appendicitis. Keywards: Acute Appendictis, RIPASA, Ultrasound.

scholarly journals Comparison of Tzanakis Score vs Alvarado Score in the Effective Diagnosis of Acute Appendicitis

2015 ◽  
Vol 12 (1) ◽  
pp. 48-50 ◽  
Author(s):  
BR Malla ◽  
H Batajoo
Keyword(s):  
Acute Appendicitis ◽  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Scoring System ◽  
Final Diagnosis ◽  
Negative Appendectomy ◽  
Alvarado Score ◽  
Effective Diagnosis ◽  
Sensitivity Specificity

Background Acute appendicitis is the most frequent surgical emergency encountered worldwide. This study was conducted to compare the efficacy of Tzanakis score and Alvarado score in diagnosing acute appendicitis.Objectives The aim of this study is to compare the efficacy of Tzanakis scoring system with Alvarado scoring system in diagnosing AA.Methods This was a retrospective and nonrandomized observational study conducted in Dhulikhel hospital. It included 200 clinically diagnosed cases of acute appendicitis who underwent emergency open or laparoscopic appendectomy during the year 2012. Final diagnosis of acute appendicitis was based on histological findings given by pathologist.Results The sensitivity, specificity, positive predictive value and negative predictive value of Tzanakis score was 86.9%, 75.0, 97.5% and 33.3% respectively. The sensitivity, specificity, positive predictive value and negative predictive value of Alvarado score was 76.0%, 75.0%, 97.2% and 21.4% respectively. Negative appendectomy was 8.0%. Conclusion Tzanakis scoring system is an effective scoring system in diagnosing acute appendicitis.Kathmandu University Medical Journal Vol.12(1) 2014: 48-50

scholarly journals A Comparative Analysis Between RIPASA and Alvarado Scoring Systems for the Diagnosis of Acute Appendicitis- A Nepalese Perspective

2018 ◽  
Vol 6 (2) ◽  
Author(s):  
Suman Baral ◽  
Neeraj Thapa ◽  
Raj Kumar Chhetri ◽  
Rupesh Sharma
Keyword(s):  
Acute Appendicitis ◽  
Positive Predictive Value ◽  
Diagnostic Accuracy ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Scoring System ◽  
Scoring Systems ◽  
Negative Appendectomy ◽  
Alvarado Score ◽  
Sensitivity Specificity

Introduction: Various diagnostic criteria have been described for acute appendicitis. For decades the most commonly used one has been Alvarado score. RIPASA scoring system has also been developed for Asian population which has shown highest sensitivity and diagnostic accuracy. This study aimed to compare these two diagnostic criteria in Nepalese population attending a tertiary center. Methods: Patients with clinically suspected acute appendicitis were classified according to both Alvarado and RIPASA scoring systems before undergoing surgery. Histopathological examination was taken as the gold standard for diagnosis. Statistical analysis was done using McNemar's test as applicable. Results: Ninety nine (90 %) patients had histologically confirmed appendicitis. With the cut-off value greater than 7.5 for RIPASA score; sensitivity, specificity, positive predictive value, negative predictive value, diagnostic accuracy and negative appendectomy rates were 94.5%, 27.27 %, 92.16 %, 37.5 %, 88.18% and 7.84% respectively. With the cut-off value greater than 7 for Alvarado score, sensitivity, specificity, positive predictive value, negative predictive value, diagnostic accuracy and negative appendectomy rates were 71.72%, 72.73 %, 95.95 %, 22.22%, 71.82 %, and 4.05 % respectively. 94.5% of patients were correctly stratified by RIPASA under higher probability group while only 71.8 % were classified by Alvarado (p value= 0.0001). Conclusion: RIPASA scoring system showed high sensitivity and diagnostic accuracy in comparison to Alvarado scoring system. So, this method can be applied in Nepalese setting for the diagnosis of acute appendicitis.

scholarly journals Clinicopathological evaluation of acute appendicitis and the role of ultrasound in diagnosis: a prospective study

2019 ◽  
Vol 6 (5) ◽  
pp. 1471
Author(s):  
Tony Mathew ◽  
Amit Shivshankar Ammanagi
Keyword(s):  
Acute Appendicitis ◽  
Positive Predictive Value ◽  
Prospective Study ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Scoring System ◽  
Lower Abdominal Pain ◽  
Negative Appendicectomy ◽  
A Prospective Study

Background: Acute appendicitis is the most common acute surgical condition of the abdomen. Delay in treatment of acute appendicitis causes lot of complication. Study was done with the objective to study the clinical and pathological presentations of acute appendicitis, to evaluate the role of ultrasound in early diagnosis of acute appendicitis and to reduce negative appendicectomy in patients.Methods: This is a prospective study done on 100 patients with acute right lower abdominal pain clinically presumed to be of appendicular origin. A thorough history, clinical examination and ultrasound scan, was done for all cases. All ultrasound positive cases were subjected to surgery and some negative cases were also taken for surgery based on clinical suspicion. The ultrasound diagnosis was compared with clinical findings, operative findings and histopathological examination reports.Results: The overall accuracy of clinical diagnosis (Alvarado scoring system) with histopathology findings was 72%. The overall sensitivity and specificity was 70.3% and 81.3% respectively and positive predictive value of was 95.2% whereas the negative predictive value was 34.2%. The overall accuracy of ultrasound with histopathology report was 93%, with a sensitivity of 96.4%, specificity of 75%, and a positive predictive value of 95% and a negative predictive value of 80%. Negative appendicectomy rate was 8.82% in females and 3.63% in males.Conclusions: The Alvarado scoring system combined with ultrasound can therefore be used as a cheap and inexpensive way of confirming acute appendicitis thus reducing negative appendicectomy rate.

scholarly journals A comparative study of RIPASA score and modified Alvarado score in diagnosis of acute appendicitis

2019 ◽  
Vol 6 (11) ◽  
pp. 3937
Author(s):  
Waleed Yusif El Sherpiny
Keyword(s):  
Acute Appendicitis ◽  
Positive Predictive Value ◽  
Diagnostic Accuracy ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Scoring System ◽  
Negative Appendectomy ◽  
Alvarado Score ◽  
Sensitivity Specificity ◽  
Ripasa Score

Background: Various diagnostic criteria have been described for diagnosing acute appendicitis. Of these, Alvarado score has been the most commonly used. The RIPASA score is a new diagnostic scoring system developed for the diagnosis of acute appendicitis and showed higher sensitivity, specificity and diagnostic accuracy as compared to Alvarado score. we want to compare prospectively Alvarado and RIPASA score by applying them to patients attending emergency department complaining of right iliac fossa pain that could probably be acute appendicitis.Methods: Patients with clinically suspected acute appendicitis were classified according to both Alvarado and RIPASA scoring systems before undergoing surgery. Histopathological examination of the removed appendix was taken as the gold standard for diagnosis of acute appendicitis.Results: Among (90%) patients had histologically confirmed appendicitis. With the cut-off value greater than 7.5 for RIPASA score; sensitivity, specificity, positive predictive value, negative predictive value, diagnostic accuracy  were 88.2%, 14.5%, 73.1%, 32%,and 68% respectively. With the cut-off value greater than 7 for Alvarado score, sensitivity, specificity, positive predictive value, negative predictive value, diagnostic accuracy and negative appendectomy rates were 51.2%, 80 %, 91 %, 29%, and 57%, respectively. 87.5% of patients were correctly stratified by RIPASA under higher probability group while only 45% were classified by Alvarado as high probability.Conclusions: RIPASA scoring system showed high sensitivity and diagnostic accuracy in comparison to Alvarado scoring system. So, it can be applied   for the diagnosis of acute appendicitis.

DIAGNOSTIC ACCURACY OF GRAY SCALE ULTRASONOGRAPHY VERSUS COLOR DOPPLER IN SUSPECTED CASES OF ACUTE APPENDICITIS

2021 ◽  
Vol 5 (1) ◽  
Author(s):  
Tahir Iqbal ◽  
Muhammad Usman Shahid ◽  
Ishfaq Ahmad Shad ◽  
Shahzad Karim Bhatti ◽  
Syed Amir Gilani ◽  
...  
Keyword(s):  
Acute Appendicitis ◽  
Positive Predictive Value ◽  
Diagnostic Accuracy ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Color Doppler ◽  
Diagnostic Tools ◽  
Gray Scale ◽  
Versus Color ◽  
Sensitivity Specificity

ABSTRACT: BACKGROUND: A common surgical emergency is acute appendicitis. Various diagnostic tools are available to diagnosis acute appendicitis. Radiological investigations play an important role in making accurate and early diagnosis and thus preventing morbidity associated with the disease. OBJECTIVE: To determine the diagnostic accuracy of gray scale ultrasonography versus color Doppler in suspected cases of acute appendicitis. MATERIALS AND METHODS: The study was carried in the department of Radiology of Mayo Hospital, Lahore. A total of 75 patients were enrolled of age 18-40 years, both genders who were suspected cases of acute appendicitis. All patients underwent baseline investigations along with gray scale ultrasonography and color Doppler. All patients were subjected to surgery to confirm the diagnosis and findings were subjected to statistical analysis. RESULTS: The mean age of the patients was 23.25 ±10.55 and mean transverse diameter of appendix was 8.37 ±3.39. There were 62.7% males and 37.3%females. Findings of gray scale ultrasonography and color Doppler were then correlated with surgical findings to calculate the diagnostic accuracy of these modalities. The results revealed that gray scale ultrasonography sensitivity, specificity, positive predictive value, negative predictive value and accuracy was 92.7%, 94.32%, 95%, 91.4% and 93.3% respectively, whereas color Doppler had sensitivity, specificity, positive predictive value, negative predictive value and accuracy of 97.7%, 93.9%, 95.3%, 97% and 96% respectively. Diagnostic accuracy of both modalities together was 98.6%. CONCLUSION: Color Doppler has better diagnostic accuracy than gray scale ultrasonography for diagnosis of acute appendicitis and the combination of both modalities yields diagnostic accuracy that is similar to gold standard.

scholarly journals A comparative study of RIPASA score and ALVARADO score in diagnosis of acute appendicitis

2018 ◽  
Vol 5 (3) ◽  
pp. 796
Author(s):  
Vamsavardhan Pasumarthi ◽  
C. P. Madhu
Keyword(s):  
Acute Appendicitis ◽  
Positive Predictive Value ◽  
Diagnostic Accuracy ◽  
Roc Curve ◽  
Predictive Value ◽  
Scoring System ◽  
Alvarado Score ◽  
Predictive Values ◽  
Sensitivity Specificity ◽  
Ripasa Score

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. Not many studies have been conducted to compare RIPASA and ALVARADO scoring systems. Hence, 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. ROC curve area analysis was performed to examine diagnostic accuracy of RIPASA and ALVARADO 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. When the ROC curve was observed the area under the curve is high for RIPASA scoring system.

scholarly journals Neutrophil-Lymphocyte Ratio Superior to Total Leukocyte and Neutrophil in Diagnosing Acute Appendicitis Using Alvarado Score

2020 ◽  
Vol 5 (6) ◽  
pp. 1388-1393
Author(s):  
Lesni Untono ◽  
Sigit Adi Prasetyo ◽  
Ignatius Riwanto
Keyword(s):  
Acute Appendicitis ◽  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Alvarado Score ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Modified Alvarado Score ◽  
Point Total ◽  
Sensitivity Specificity

Background: The diagnosis of acute appendicitis must be performed quickly and accurately to reduce the risk of negative appendectomy without increasing the risk of perforation. Objective: To analyze whether Neutrophil-Lymphocyte Ratio (NL-R) in the modified Alvarado score is more accurate in diagnosing acute appendicitis in comparison with total leukocyte and neutrophil. Method: This was a cross-sectional study and the data were collected from Telogorejo Hospital Semarang (Indonesia) from November 2018 until October 2019. The best cut-off point of NL-R for predicting acute appendicitis was provided through receiver operating characteristic (ROC) curve. NL-R was used to replace total leukocyte and neutrophil to form a modified Alvarado score. Area Under Curve (AUC), sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of the original Alvarado Score and modified Alvarado score were measured. Results: Sensitivity, specificity, positive predictive value, negative predictive value of the original Alvarado score are 100%, 84.6%, 91.3%, and 100% respectively with cut-off point total score of >4.5. Sensitivity, specificity, positive predictive value, negative predictive value of modified Alvarado score were 100%, 100%, 100%, and 100% respectively with cut-off point total score of >5.5. AUC modified Alvarado Score was 1.000 and AUC original Alvarado Score was 0.985. Conclusion: Modified Alvarado score diagnoses acute appendicitis more accurately than the original Alvarado Score.

scholarly journals Modified alvarado score in diagnosis of acute appendicitis: a clinicopathological study

2018 ◽  
Vol 5 (3) ◽  
pp. 878
Author(s):  
Sanjay Jain ◽  
Ajay Gehlot ◽  
M. C. Songra
Keyword(s):  
Abdominal Pain ◽  
Acute Appendicitis ◽  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Scoring System ◽  
Alvarado Score ◽  
Diagnostic Modality ◽  
Delay In Diagnosis ◽  
Modified Alvarado Score

Background: Acute appendicitis is one of the commonest surgical emergencies in all ages. Diagnosis is mainly clinical, delay in diagnosis definitely increases the morbidity, mortality and cost of treatment, more aggressive surgical approach has resulted in increased white appendectomies.Methods: A total 100 cases hospitalized with abdominal pain, suggestive of acute appendicitis on the basis of modified Alvarado scoring system and were subsequently operated, were included in the present study in our institute for period of 20 Months.Results: Males belonging to young age group of 21-30 were most commonly affected. Abdominal pain was seen in 100% of patients. Fever seen in 87% of patients and vomiting in78%. Modified Alvarado score of 9 had positive predictive value of 100% while negative predictive value 8.9%, while score between 7-8 had positive predictive value of 98.9% and negative predictive value 27.8%. The sensitivity was 86.1% and specificity was 83.3%. The ultrasonography showed a sensitivity of 94.68%. In present study rate of total white appendectomy was 6%. The Modified Alvarado scoring system is a reliable and practicable diagnostic modality to increase the accuracy in diagnosis of acute appendicitis and thus to minimise unnecessary appendectomy.Conclusions: Young males are most commonly affected almost always presents with abdominal pain. The Modified Alvarado scoring system is a reliable and practicable diagnostic modality to increase the accuracy in diagnosis of acute appendicitis and thus to minimise unnecessary appendectomy.

scholarly journals Comparision of ultrasonographic diagnosis with ‘Tzanakis’ Score in acute appendicitis

2016 ◽  
Vol 19 (1) ◽  
pp. 9-12
Author(s):  
Ashish Prasad Rajbhandari ◽  
Nischal Dhakal ◽  
Robin Koirala ◽  
Manohar Lal Shrestha
Keyword(s):  
Acute Appendicitis ◽  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
College Teaching ◽  
Medical College ◽  
Ultrasonographic Diagnosis ◽  
Ultrasound Findings ◽  
Sensitivity Specificity ◽  
Better Than

Introduction: Acute appendicitis is one of the most common acute surgical abdominal conditions requiring surgery. Ever since the inflamed appendix was demonstrated in the 1980’s by Ultrasonography, it has been used as an aid to clinically diagnose acute appendicitis. Tzanakis scoring system is a combination of clinical examination, Ultrasonography and inflammatory markers. Methods: A retrospective non-randomized observational study was conducted from April 2014 to March 2015 on all cases of acute appendicitis, which underwent preoperative ultrasound before appendectomy (open/laparoscopic) at the Department of surgery, Nepal Medical College Teaching Hospital. Ultrasound findings and Tzanaki score were compared in the cases. No studies could be found in literature comparing ultrasound diagnosis with Tzanaki score in appendicitis. Results: The sensitivity, specificity, positive predictive value and negative predictive value of ultrasound were 73%, 50%, 95% and 12% respectively. The sensitivity, specificity, positive predictive value and negative predictive value of Tzanaki were 87%, 50%, 96% and 23% respectively. Tzanaki score is better than ultrasound alone as a diagnostic test for acute appendicitis. Conclusion: Tzanaki score is better than ultrasound in diagnosis of acute appendicitis.  

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