COMPARISON OF ALVARADO SCORE AND RIPASA SCORE IN THE DIAGNOSIS OF ACUTE APPENDICITIS IN THE EMERGENCY DEPARTMENT
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Abstract
BACKGROUND: The Alvarado and RIPASA scores have been shown to have significantly different sensitivity, specificity, and accuracy when used to diagnose acute appendicitis. Complications can be avoided with an accurate diagnosis and prompt appendectomy.
OBJECTIVE: To compare the sensitivity, specificity, and accuracy of the Alvarado score and the RIPASA score in the diagnosis of acute appendicitis in the emergency room.
METHODS: This was a diagnostic accuracy research applying prospective design in patients with lower right abdominal pain and suspected appendicitis in the emergency department of Chiangkham Hospital, Phayao Province between September 1, 2022, and December 31, 2022.
The accuracy of the Alvarado score was compared to the RIPASA score by determining the sensitivity, specificity, accuracy, and area under the curve (AUC). The level of statistical significance was set at 0.05.
RESULTS: Of the 119 patients with lower right abdominal pain and appendectomy, 90 cases were diagnosed as acute appendicitis and their mean age was 43.77 years with similar gender distribution. The mean Alvarado and RIPASA scores were 8 and 10.5, respectively. The Alvarado and RIPASA scores among patients with acute appendicitis were statistically higher than those without the disease (p=0.031). Based on the ROC curve, the RIPASA score at the cut-off point ≥ 7.5 was 90% sensitive, 89.66% specific, and 89.92% accurate with AUC=0.93 (95%CI=0.88-0.98). On the other hand, the Alvarado score at ≥ 7 had 82.22% sensitivity, 79.31% specificity, 81.50% accuracy, and AUC was 0.86 (95% CI=0.79-0.94).
CONCLUSIONS AND RECOMMENDATIONS: The RIPASA score was more sensitive and accurate in diagnosing acute appendicitis than the Alvarado score, therefore should be used as a criterion for referral and admission to the hospital.
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