SIGNIFICANCE OF RIPASA SCORING SYSTEM IN DIAGNOSIS OF ACUTE APPENDICITIS

Marwah Karan; Maheshwari Kumar Mukesh

Volume : VI, Issue : VII, July - 2016

SIGNIFICANCE OF RIPASA SCORING SYSTEM IN DIAGNOSIS OF ACUTE APPENDICITIS

Marwah Karan, Maheshwari Kumar Mukesh

Abstract :

Background:Acute appendicitis is one of the commonest surgical emergencies. The risks of two primary outcomes must be balanced in the management of presumed appendicitis: perforation and misdiagnosis.Methods:Data was collected from 96 patients with complains of right iliac fossa pain over a period of 2 years in our hospital. All patients were categorised using the RIPASA SCORE. The preoperative and histological findings were compared with the preoperative diagnosis.Results:Histopathologically 91 patients were in appendicitis groups and 5 patients were in no appendicitis group.On Evaluation of scoring system in the present study, RIPASA system was found sensitive (97.80%), specificity of RIPASA score (77%). Positive predictive value of score came out to be 98.89% in RIPASA . Negative predictive value of RIPASA system was 66.67%. Accuracy is 89.04% in RIPASA system. Predicitive negative appendectomy rate by application of score is 0.7% by RIPASA system.ROC analysis was done to depict the cut off with maximum sensitivity and specificity. RIPASA cut off was found to be 8.5 as compared to the original cut off 7.5.Conclusion:It was observed in the present study that there has been an increase in mean scores in the scoring system, with an increase in histopathological severity. Presence of gangrene was found statistically significant at RIPASA score ≥12. It can be concluded that there is high possibility to find gangrenous appendix when the RIPASA score are greater than 12. On considering the above fact it is observed that RIPASA score is more accurate and more sensitive to diagnose acute appendicitis than other scoring system.