Comparative study of Raja Isteri Pengiran Anak Saleha Appendicitis (RIPASA) and modified Alvarado score in the accuracy of diagnosis of the acute appendicitis

Background: Accurate diagnosis of acute appendicitis is crucial to avoid complications. The traditional Alvarado score's diagnostic accuracy varies, especially in Asian populations. To address these limitations, the Raja Isteri Pengiran Anak Saleha Appendicitis (RIPASA) score was developed. Aim and objectives; This study, conducted at Al Zahraa University Hospital, compares the diagnostic accuracy of the RIPASA score with the modified Alvarado score in diagnosing acute appendicitis. The prospective study included 100 patients aged 16-50 years with right iliac fossa pain. Subjects and methods; Both RIPASA and modified Alvarado scores were calculated for each patient. Of these patients, 58% were male, and 85% were 40 years old or younger. Result: The RIPASA score ranged from 5.5 to 15, with an average of 9.07 ± 1.66, while the modified Alvarado score ranged from 1 to 10, averaging 6.22 ± 1.77. The RIPASA score showed a sensitivity of 53.9%, specificity of 77.8%, and accuracy of 71% at a cutoff of ≥7.5. In contrast, the modified Alvarado score showed a sensitivity of 12%, specificity of 100%, and accuracy of 20% at a cutoff of ≥7. Conclusion: We concluded that the RIPASA score had higher sensitivity, specificity, and overall diagnostic accuracy compared to the modified Alvarado score for diagnosing acute appendicitis in this population. The enhanced diagnostic performance of the RIPASA score supports its reliability as a diagnostic tool.