A Comparitive Study of Alvarado Score And Ripasa Score in the Diagnosis Of Acute Appendicitis

Acute Appendicitis is one of the most common surgical emergencies in clinical practice with estimated life time prevalence approximately 1 in 7. [1] The incidence is 1.5 to 1.9 per 1000 and is approximately 1.4 times greater in men then in women. [2] Aim: This study was undertaken to compare Alvarado and RIPASA score to diagnose acute appendicitis ,to know the efficacy of individual score for early diagnosis of acute appendicitis. to improve the diagnostic criteria for acute appendicitis Material and Methods: The comparative study of two scores in the diagnosis of acute appendicitis involved 200 patients admitted in teaching hospital. Results: RIPASA scoring system is more sensitive (98.42%) as compared to the Alvarado scoring system (73.7%). RIPASA score is more specific (90%) as compared to Alvarado scoring system (80%). PPV of RIPASA scoring system is 99.46% as compared to 94.32% of the Alvarado scoring system. NPV of the RIPASA scoring system is 75% while that of Alvarado scoring system is 3.38%. ROC analysis depicts the cut off point for the diagnosis with maximum sensitivity and specificity for the RIPASA scoring system to be at 7 which is different from the original cut off value of 7.5. Conclusion: Both Alvarado and RIPASA score have significant difference when Non-Parameteric Pearson Chi Square TEST was applied with p value <0.05, fairly the correlation between the Alvarado and RIPASA Score rho = 0.538 and p value <0.05,significant difference was found with positive agreement between the two scores .From the above parameters we conclude that in our present study RIPASA Score is a better Score in diagnosing the cases of acute appendicitis as compared to the Alvarado score .Still due to lack of studies done for RIPASA Score we need more studies to be conducted on Asian population to prove that the new score is a better score in diagnosing acute appendicitis .