scholarly journals Comparison of RIPASA and Alvarado scoring in the diagnosis of acute appendicitis and validation of RIPASA scoring

2019 ◽  
Vol 6 (3) ◽  
pp. 935
Author(s):  
Jeevan G. Sanjive ◽  
Ravi H. Ramaiah
Keyword(s):  
Emergency Department ◽  
Acute Appendicitis ◽  
Diagnostic Accuracy ◽  
Predictive Value ◽  
Scoring System ◽  
Operating Characteristic ◽  
Surgical Emergencies ◽  
Negative Appendicectomy ◽  
Sensitivity Specificity ◽  
Higher Sensitivity

Background: Acute appendicitis is one of the most common surgical emergencies. A delay in performing an appendicectomy in order to improve the diagnostic accuracy increases the risk of appendicular perforation and sepsis. We prospectively compared and validated RIPASA to Alvarado scoring system when applied to an Indian population.Methods: This study included all the patients presented in General Surgery and The Emergency Department of Manipal Hospital, Bangalore diagnosed to have acute appendicitis from October 2014 to March 2016. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), diagnostic accuracy, predicted negative appendicectomy and receiver operating characteristic (ROC) curve of the RIPASA and Alvarado scoring system were derived using SPSS statistical software.Results: 75 patients were included in the study. Using the RIPASA scoring system, 97.1% of patients who actually had acute appendicitis were correctly diagnosed, compared to only 52.85% when using the Alvarado scoring system. The sensitivity and the specificity of the RIPASA scoring system is 97.14% and 60% respectively. The diagnostic accuracy of RIPASA scoring system is 94.67% and that of Alvarado scoring system is 52%. The results indicate that the RIPASA scoring system is a better diagnostic tool for the diagnosis of acute appendicitis (p<0.001).Conclusions: It is observed that the RIPASA scoring system has higher sensitivity and higher specificity compared to Alvarado scoring. It also has higher diagnostic accuracy and consequently, it has low negative appendicectomy rate. It can be concluded that the RIPASA scoring can be effectively conducted for the better evaluation of acute appendicitis.

scholarly journals Comparison of RIPASA and Alvarado score in diagnosing acute appendicitis

2019 ◽  
Vol 6 (3) ◽  
pp. 740
Author(s):  
Suraj S. Kagwad ◽  
P. Karuppasamy
Keyword(s):  
Acute Appendicitis ◽  
Diagnostic Accuracy ◽  
Predictive Value ◽  
Scoring System ◽  
Cost Effective ◽  
Clinical History ◽  
Alvarado Score ◽  
Negative Appendicectomy ◽  
Sensitivity Specificity ◽  
Ripasa Score

Background: Acute appendicitis is a common cause of abdominal pain and can be difficult to diagnose, especially during its early stages.  The diagnosis of acute appendicitis is based on clinical history, examination combined with investigations. The purpose of this study is to compare between the RIPASA score and Alvarado score in the diagnosis of acute appendicitis. The aim of the present study was to compare the sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of Alvarado and RIPASA score.Methods: The cases for the study will be sourced from cases admitted in SVMCH and RC, Puducherry during the period of November 2016 to June 2018.Results: Out of the 144 patients in our study 133 patients were diagnosed with acute appendicitis as per HPE report.As per our study, sensitivity, specificity, PPV, NPV of RIPASA and Alvarado scoring system is 96.2%, 57.1%, 97.7% and 44.4%; 81.9%,85.7%, 95.1% and 20%  respectively. The diagnostic accuracy of RIPASA score is 94.3 as compared to 82.1 of Alvarado score.Conclusions: The RIPASA scoring system is a promising and has good sensitivity, specificity and diagnostic accuracy when compared to Alvarado scoring for Asian Population.RIPASA scoring system is an easy and reliable, cost effective diagnostic tool which reduce negative appendicectomy rates and the expensive radiological investigations for the diagnosis of acute appendicitis.

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 COMPARISON OF ALVARADO SCORE AND RIPASA SCORE IN THE ACCURATE DIAGNOSIS OF ACUTE APPENDICITIS IN COMBINED MILITARY HOSPITAL RAWALPINDI

2021 ◽  
Vol 71 (5) ◽  
pp. 1519-23
Author(s):  
Muhammad Majid ◽  
Rasikh Maqsood ◽  
Muhammad Ali ◽  
Muhammad Ayub Ashraf Malhi ◽  
Zaki Hussain ◽  
...  
Keyword(s):  
Emergency Department ◽  
Acute Appendicitis ◽  
Diagnostic Accuracy ◽  
Predictive Value ◽  
Military Hospital ◽  
Alvarado Score ◽  
Accident And Emergency ◽  
Accident And Emergency Department ◽  
Sensitivity Specificity ◽  
Ripasa Score

Objective: To determine the diagnostic accuracy of Alvarado score and the RIPASA score for acute appendicitis using histopathology as a gold standard. Study Design: Cross sectional validation study. Place and Duration of Study: Department of General Surgery, Combined Military Hospital, Rawalpindi Pakistan, from Mar to Sep 2018. Methodology: A total number of 270 patients were included in the study presenting with pain right iliac fossa to the Accident and Emergency department. Surgeons and Seniors Residents in Surgery on call in the Accident and Emergency Department. Combined Military Hospital, Rawalpindi, scored the patients with suspicion of acute appendicitis with Alvarado Score and RIPASA score simultaneously. After appendectomy of these patients, the removed appendix was sent for histopathology to confirm whether it was normal or inflamed. A 2x2 table was used for calculating sensitivity, specificity and diagnostic accuracy of the RIPASA score and Alvarado Score. The two scoring systems were then compared for diagnostic accuracy. Results: In our study, the sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of RIPASA score and Alvarado score for diagnosing acute appendicitis were 92.1%, 62.1%, 95.2%, 48.6%, 88.9% and 72.6%, 68.9%, 95.1%, 23.2%, 72.2% respectively. Conclusion: The diagnostic accuracy of RIPASA score was more than that of Alvarado score in diagnosing acute appendicitis.

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 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 A COMPARATIVE STUDY OF TZANAKIS SCORE VS ALVARADO SCORE IN THE DIAGNOSIS OF ACUTE APPEDICITIS

2020 ◽  
pp. 39-41
Author(s):  
Shouryabrata Choudhury ◽  
Bhaskar Sharma ◽  
Neelanjana Paul
Keyword(s):  
Acute Appendicitis ◽  
Predictive Value ◽  
Scoring System ◽  
Open Appendectomy ◽  
Scoring Systems ◽  
Alvarado Score ◽  
Duration Of Symptoms ◽  
Medical College ◽  
Negative Appendicectomy ◽  
Sensitivity Specificity

Background: Acute appendicitis is the most common cause of sudden abdominal pain requiring surgery. Prolong duration of symptoms before the surgical intervention increases the risk of morbidity and mortality due to perforation. There have been several scoring systems to help the decision making process to reach diagnosis of acute appendicitis. ALVARADO and modified ALVARADO are the two most commonly used system worldwide. This study is being done to assess the accuracy of the TZANAKIS SCORING SYSTEM and ALVARADO SCORING SYSTEM in the diagnosis of acute appendicitis and reduce the rate of negative appendicectomy. Methodology: This was a hospital based prospective observational study conducted on patients admitted in the Department of General Surgery, Silchar Medical college and Hospital. This study was based on the analysis of 100 patients diagnosed to have acute appendicitis and underwent emergency open appendectomy from March 1st ,2020 – August 31st 2020. Aims and objectives: The aim of the present study is to assess the compare the accuracy of TAZANAKIS Scoring system and ALVARDO scoring system in the diagnosis of acute appendicitis. Results: The sensitivity, specificity, positive predictive value and negative predictive value of Tzanakis score was 83.72, 78.57, 96.0 and 44.0 respectively and of Alvarado score was 65.11, 35.71, 86.1 and 14.28 respectively. Negative appendicectomy was 14%. Conclusion: Tzanakis scoring system is an effective scoring system to establish the accurate diagnosis of acute appendicitis and helps in reducing negative appendicectomy rate.

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 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.

scholarly journals Augmentation of modified Alvarado score with abdominal ultrasound in diagnosis of acute appendicitis

2020 ◽  
Vol 8 (1) ◽  
pp. 111
Author(s):  
Shipra Sharma ◽  
Ankit Soni ◽  
Sanjay Kumar ◽  
Manoj Poptani
Keyword(s):  
Acute Appendicitis ◽  
Predictive Value ◽  
Abdominal Ultrasound ◽  
Laboratory Findings ◽  
Alvarado Score ◽  
Surgical Emergencies ◽  
Increased Sensitivity ◽  
Negative Appendicectomy ◽  
Modified Alvarado Score ◽  
Sensitivity Specificity

Background: Acute appendicitis is one of the commonest surgical emergencies. But confirming the diagnosis of acute appendicitis is still a subjective issue for clinicians. Modified Alvarado score is based on clinical and laboratory findings which is scored upto 9. Management of 5 to 7 modified Alvarado score came under equivocal. Either may be conservative or operative.Methods: We augmented the modified Alvarado score with abdominal ultrasound in diagnosis of acute appendicitis.Results: Outcomes were evaluated in terms of sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and negative appendicectomy rate, results of our study are sensitivity 95.7%, specificity is 76.92%, PPV 93.75% and NPV 33.34%.Conclusions: Overall increased sensitivity, specificity, NPV and PPV of the augmented approach is useful for diagnosis of acute appendicitis which scored under 5-7 of modified Alvarado scoring system.

scholarly journals Augmentation of modified Alvarado score with abdominal ultrasound in diagnosis of acute appendicitis

2020 ◽  
Vol 7 (3) ◽  
pp. 853
Author(s):  
Manoj Poptani ◽  
Ankit Soni ◽  
Shipra Sharma ◽  
Sanjay Kumar
Keyword(s):  
Acute Appendicitis ◽  
Predictive Value ◽  
Abdominal Ultrasound ◽  
Laboratory Findings ◽  
Alvarado Score ◽  
Surgical Emergencies ◽  
Increased Sensitivity ◽  
Negative Appendicectomy ◽  
Modified Alvarado Score ◽  
Sensitivity Specificity

Background: Acute appendicitis is one of the commonest surgical emergencies. But confirming the diagnosis of acute appendicitis is still a subjective issue for clnicians. Modified Alvarado score is based on clinical and laboratory findings which is scored upto. Management of 5 to 7 modified Alvarado score came under equivocal. Either may be conservative or operative.Methods: We augmented the modified alvarado score with abdominal ultrasound in diagnosis of acute appendicitis.Results: Outcomes were evaluated in terms of sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and negative appendicectomy rate, results of our study are sensitivity 95.7%, specificity is 76.92%, PPV 93.75% and NPV 33.34%.Conclusions: Overall increased sensitivity, specificity, NPV and PPV of the augmented approach is useful for diagnosis of acute appendicitis which scored under 5-7 of modified alvarado scoring system.  

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