COMPARISON OF DIAGNOSTIC ACCURACY OF ALVARADO SCORE AND RIPASA SCORING SYSTEM IN DIAGNOSIS OF ACUTE APPENDICITIS

BACKGROUND : Acute appendicitis is one of the most common surgical emergencies, frequently presenting with abdominal pain, often located in the right lower quadrant (RLQ). Despite its prevalence, diagnosing acute appendicitis remains challenging due to the variability in clinical presentation and the anatomical heterogeneity of the appendix. OBJECTIVE : To compare the diagnostic accuracy of ALVARADO and RIPASA scoring systems in the diagnosis of acute appendicitis, keeping histopathology as the standard reference. METHODOLOGY : This cross-sectional comparative validation study was conducted at CMH Rawalpindi from July 1, 2023, to December 31, 2023, and included 61 patients who met the inclusion criteria. ALVARADO and RIPASA scores were calculated pre-operatively in patients following laparoscopic appendectomy. The removed appendix was then sent for histopathological diagnosis. A 2x2 table was drawn for calculating diagnostic accuracy parameters. Data was analyzed by the Statistical Package for Social Sciences version 20. RESULTS : In comparison to histopathological assessment, the accuracy, sensitivity, specificity, positive predictive value, and negative predictive value of RIPASA score to diagnose acute appendicitis was 91.80%, 95.65%, 80.00%, 93.62%, and 85.71% while for ALVARADO score these values were 85.25%, 91.30%, 66.67%, 89.36%, and 71.43%, respectively. CONCLUSION : The accuracy of the RIPASA scoring system is higher as compared to the ALVARADO score in diagnosing acute appendicitis. KEYWORDS : ALVARADO score, Appendicitis, Appendectomy, Diagnostic accuracy, RIPASA score