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Category: Volume 07 Issue 07 July 2019
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Title: Use of Ripasa Score in the Diagnosis of Acute Appendicitis: A Pilot Study from West Bengal, India

Authors: Malay Kumar Barman, Kaustav Das, Koel Mukherjee

 DOI: https://dx.doi.org/10.18535/jmscr/v7i7.26

Abstract

Acute appendicitis is the most common cause of abdominal emergency in both developed and developing countries. Several scoring systems have been developed in order to aid the decision-making process to reach diagnosis of acute appendicitis in the quickest and cheapest way. Of which the Alvarado and the Modified Alvarado Scoring Systems (MASS) are the two most commonly used scoring systems worldwide. In a recent study conducted in Brunei, Darussalam from Nov 2008 to April 2009 hypothesized a new scoring system named as Raja Isteri Pengiran Anak Saleha Appendicitis (RIPASA) scoring. The study claimed that this scoring system is having much more sensitivity, specificity, positive and negative predictive value than other scoring system. Therefore, present study has tried to assess the diagnostic accuracy of RIPASA scoring system among the patients undergoing emergency appendicectomy in a rural hospital from West Bengal. A total of 88 patients including 42 males and 46 females admitted for emergency appendicectomy during 2015-2016 have been considered for present study. Before commencement of the study the purpose of the study and consent has been obtained from the studied patients. Clinical investigation and histopathological report also compared with the RIPASA score. Data revealed that RIPASA has Sensitivity of 97.14%, Specificity of 77.78%, Positive Predictive Value (PPV) of 94.44%, Negative Predictive Value (NPV) of 87.5% and Diagnostic Accuracy of 93.18%. This result corroborated with other studies from different parts of the world.

 So it can be recommended from the present study that for quick and early diagnosis for acute appendicitis and to avoid the negative appendicectomy as much as possible and reduce the morbidity and mortality and economic burden related to negative appendicectomy RIPASA score can be used as a much more advanced scoring system than MASS with higher rate of diagnostic accuracy.

Keywords: RIPASA, Acute Appendicitis, MASS, Histopathology.

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Corresponding Author

Dr Malay Kumar Barman

Associate Professor, Department of General Surgery, North Bengal Medical College, Darjeeling, West Bengal, India