Effective diagnosis of acute appendicitis - comparison of RIPASA and Alvarado scoring systems
JSP-Journal of Surgery Pakistan International. 2016; 21 (3): 88-91
em En
| IMEMR
| ID: emr-186772
Biblioteca responsável:
EMRO
Objective: To compare the diagnostic usefulness of RIPASA and Alvarado score in identifying patients with acute appendicitis presenting with right iliac fossa pain
Study design: Cross sectional analytical
Place and Duration of study: Department of Surgery Unit III, Jinnah Postgraduate Medical Centre [JPMC] Karachi, from December 2013 to December 2015
Methodology: All patients above 15 year age of either sex with right iliac fossa pain, were included in the study. All patients were clinically assessed and scored as per Alvarado and RIPASA scoring systems. Decision for appendectomy was based on the surgeon's clinical judgment. The scoring systems were used for the study purpose. The histopathological findings were compared with the scores of the two systems
Results: Using RIPASA scoring criterion, 172 [86%] patients were suspected to have acute appendicitis. Out of these 164 patients had acute appendicitis on histopathology report [true positive - TP] where as 8 were false positive [FP], 16 false negative [FN] and 12 true negative [TN] for acute appendicitis. Using Alvarado score, only 22 [11%] were suspected to have acute appendicitis. A total 21 patients were confirmed true positive [TP] based on histopathology, only one false positive [FP], 159 false negative [FN] and 19 true negative [TN]. The sensitivity of RIPASA score was 91.11%, specificity 60%, PPV 95.34%, NPV 42.85%, diagnostic accuracy 88% and rate of negative appendicectomy was 10.25%. Sensitivity of Alvarado score was 11.67%, specificity 95%, PPV 95.45%, NPV 10.67%, diagnostic accuracy 20% and negative appendicectomy rate was 0.132%
Conclusion: The RIPASA score was reliable and sensitive diagnostic tool to make diagnosis of acute appendicitis
Study design: Cross sectional analytical
Place and Duration of study: Department of Surgery Unit III, Jinnah Postgraduate Medical Centre [JPMC] Karachi, from December 2013 to December 2015
Methodology: All patients above 15 year age of either sex with right iliac fossa pain, were included in the study. All patients were clinically assessed and scored as per Alvarado and RIPASA scoring systems. Decision for appendectomy was based on the surgeon's clinical judgment. The scoring systems were used for the study purpose. The histopathological findings were compared with the scores of the two systems
Results: Using RIPASA scoring criterion, 172 [86%] patients were suspected to have acute appendicitis. Out of these 164 patients had acute appendicitis on histopathology report [true positive - TP] where as 8 were false positive [FP], 16 false negative [FN] and 12 true negative [TN] for acute appendicitis. Using Alvarado score, only 22 [11%] were suspected to have acute appendicitis. A total 21 patients were confirmed true positive [TP] based on histopathology, only one false positive [FP], 159 false negative [FN] and 19 true negative [TN]. The sensitivity of RIPASA score was 91.11%, specificity 60%, PPV 95.34%, NPV 42.85%, diagnostic accuracy 88% and rate of negative appendicectomy was 10.25%. Sensitivity of Alvarado score was 11.67%, specificity 95%, PPV 95.45%, NPV 10.67%, diagnostic accuracy 20% and negative appendicectomy rate was 0.132%
Conclusion: The RIPASA score was reliable and sensitive diagnostic tool to make diagnosis of acute appendicitis
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Índice:
IMEMR
Tipo de estudo:
Diagnostic_studies
/
Prognostic_studies
Idioma:
En
Revista:
J. Surg. Pak. Int.
Ano de publicação:
2016