Evaluation Of Ripasa Scoring System In Diagnosis Of Acute Appendicitis; One Year Prospective Study

Abstract

Background and Objectives Various scoring systems are being used to aid the diagnosis of acute appendicitis and RIPASA score is the new diagnostic scoring system based on extensive yet simple parameters. The present study evaluated its accuracy in the diagnosis of acute appendicitis. Methodology This one year hospital study was conducted in the Department of General Surgery, KLES Dr. Prabhakar Kore Hospital and Medical Research Centre, Belgaum. A total of 60 patients presenting with right Illiac fossa pain from January 2014 to December 2014 were enrolled. The patients were evaluated for all the variables required to obtain RIPASA scores. Results Fifty percent (50%) of the patients each were males and females with male to female ratio of 1:1. Most of the patients (71.67%) were aged between 18 to 30 years and mean age was 27.1 ± 8.81 years. Other than RIF pain, common symptoms were nausea and vomiting (96.67%), pain migration of RIF (80%), anorexia (70%), fever (61.67%) and commonest clinical sign was RIF tenderness (95%). The duration of pain was <48 hours in 88.33% of the patients. Urine analysis was negative in 83.33% while WBC count of ≥ 10000 was noted in 65% of the patients. Most of the patients (60%) had RIPASA scores from 11 to 15. The HPR report revealed 53.33% of the patients with acute appendicitis. Significantly higher number of patients with ≥7.5 RIPASA score were diagnosed to have acute appendicitis (98.04% vs 33.33%; p<0.001) and showed sensitivity, specificity, positive predictive value and negative predictive value as 94.34%, 85.71%, 98.04% and 66.67% respectively (positive likelihood ratio of 6.60). Conclusion and interpretation The RIPASA scoring system which is based on simple parameters that can be ascertained by complete history, clinical examination and few investigations is a valuable scoring system in the diagnosis of acute appendicitis.