Comparative study to access efficacy of modified alvarado scoring system versus ripasa scoring system in effective diagnosis of patients with acute appendicitis in a tertiary care hospital –a one year prospective analytical study

Abstract

Introduction- Acute appendicitis is the most common cause of acute abdomen requiring surgery. Acute appendicitis has lifetime incidence of 8.6% in males and 6.7% in females. The accuracy of clinical examination in diagnosing acute appendicitis is 70-87%. Approx. 20-30% of patients with suspected acute appendicitis have atypical findings making clinical diagnosis difficult. Clinical scoring systems were developed to reduce the negative appendectomy rate to 5%–10%. The most popular scoring system among surgeons is the Alvarado score, which was developed in 1986 as the simple addition of points related to eight clinical parameters. The modified Alvarado score omitted the last point of the original score (shift to the left Neutrophils) . It has been shown that there were no significant differences between the outcomes of the two scores. More recently, a new clinical scoring system was established, called the Raja Isteri Pengiran Anak Saleha Appendicitis (RIPASA) score, and it was developed in 2008 at the Department of Surgery, Raja Isteri Pengiran Anak Saleha Hospital, Brunei Darussalam. This score includes 14 clinical parameters, and has a higher sensitivity, specificity and diagnostic accuracy than the Alvarado scoring system, especially in Asian population. The diagnosis of acute appendicitis is often a challenging job for surgeon so my study will help to find a scoring system which is more efficient in diagnosing the problem early & henceforth less complications.

Aim Compare of efficacy of Modified Alvarado Scoring System with RIPASA Scoring system in diagnosing Acute Appendicitis.