Modified ALVARADO and RIPASA Score Systems in Acute Appendicitis: A Diagnostic Comparative Accuracy Study

Background: One of the most common surgical emergencies include acute appendicitis which has a lifetime prevalence of one in seven with mortality rates ranging from 1-5% and morbidity rates of 10%. The diagnosis of acute appendicitis is challenging as it mimics many other acute medical and surgical conditions. This study aims to compare the diagnostic accuracy of both scoring systems to avoid potentially serious outcomes by analysing clinical and laboratory parameters.Objective: This study aimed to compare the usefulness of the RIPASA score and Alvarado scores for diagnosing patients with abdominal pain and suspected acute appendicitis to increase diagnostic accuracy.Methods: This is a retrospective observational study conducted in the Department of General Surgery for one year duration in. 500 patients with Acute Appendicitis.Results: The sensitivity of the RIPASA and Alvarado score was 41.1% and 17.8% respectively. Specificity of the RIPASA score and Alvarado score was 93.4% and 98.9% respectively. The diagnostic accuracy of the RIPASA score is 50.6% compared to 32.6% for Alvarado score. Five patients (2%) with acute appendicitis were misdiagnosed using the Alvarado score compared to the RIPASA score. Conclusion: RIPASA scoring system provides more accuracy in the diagnosis of acute appendicitis with detailed clinical and laboratory details especially in the South Indian population compared to the Alvarado scoring system.