Accuracy of Raja Isteri Pengiran Anak Saleha Appendicitis Score (RIPASA) in Diagnosis of Acute Appendicitis

Abstract

Objective: To evaluate the diagnostic precision of the RIPASA score in diagnosing acute appendicitis by
using histopathology as the benchmark.
Material and Methods: A cross-sectional validation research was conducted at Ghurki trust Teaching
Hospital, Lahore, Pakistan. A total of 112 patients between 16-70 years of age, either gender, presenting with
suspected acute appendicitis and ready to undergo appendectomy were included. Patients having a right iliac
fossa mass, past experience of abdominal trauma, pregnancy and who were already receiving therapy for
urolithiasis and pelvic inflammatory disease were excluded. These patients were evaluated by the RIPASA
score. Patients were labelled as either negative or positive. A single surgical team performed either open or
laparoscopic appendicectomies under general anaesthesia on these patients. Appendicectomy specimen's
histopathology reports were reviewed, and patients were verified as either positively or negatively for acute
appendicitis.
Results: The RIPASA scoring system was able to diagnose acute appendicitis taking histopathology as the
gold standard with a diagnostic accuracy of 88.39%, specificity of 75.0%, sensitivity of 93.75%, positive
predictive value of 90.36% and negative predictive values of 82.76%.
Conclusion: This study concludes that RIPASA scoring system is an effective as well as straightforward
method to diagnose acute appendicitis, demonstrating high sensitivity and accuracy.
Keywords: RIPASA score, Alvarado score