Comparison of Alvarado score, appendicitis inflammatory response score (AIR) and Raja Isteri Pengiran Anak Saleha appendicitis (RIPASA) score in predicting acute appendicitis

Introduction: Acute Appendicitis is the most common surgical emergency encountered in emergency departments. To prevent the rate of negative appendectomies, different systems i.e. Alvarado score and Appendicitis Inflammatory Response Score (AIR) scores were used, but their diagnostic accuracy in Asi...

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Main Authors: Muhammad Zeb, Sabir Khan Khattak, Maryam Samad, Syed Shayan Shah, Syed Qasim Ali Shah, Abdul Haseeb
Format: Article
Language:English
Published: Elsevier 2023-01-01
Series:Heliyon
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S2405844023002207
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author Muhammad Zeb
Sabir Khan Khattak
Maryam Samad
Syed Shayan Shah
Syed Qasim Ali Shah
Abdul Haseeb
author_facet Muhammad Zeb
Sabir Khan Khattak
Maryam Samad
Syed Shayan Shah
Syed Qasim Ali Shah
Abdul Haseeb
author_sort Muhammad Zeb
collection DOAJ
description Introduction: Acute Appendicitis is the most common surgical emergency encountered in emergency departments. To prevent the rate of negative appendectomies, different systems i.e. Alvarado score and Appendicitis Inflammatory Response Score (AIR) scores were used, but their diagnostic accuracy in Asian population is questionable. Raja Isteri Pengiran Anak Saleha (RIPASA) score has showed promising results in the recent literature. The purpose of this study is to compare the efficacy of Alvarado, AIR and RIPASA scores in the diagnosis of acute appendicitis. Methods: Alvarado, AIR and RIPASA scores were prospectively applied to 132 included patients that were admitted with provisional diagnosis of acute appendicitis and then their surgery was performed in General Surgery Unit, Hayatabad Medical Complex Peshawar, Pakistan from 1st January 2022 to 31st July 2022. Final diagnosis was confirmed by histopathology report and scores were correlated with final report. Cut off value of score >7, >5 and >7.5 were set for Alvarado, AIR and RIPASA score, respectively according to previous literature. Statistics analysis was done for all 3 scoring systems on SPSS version 23. Results: Of 132 patients, there were n = 79(59.8%) males and n = 53(40.2%) females. Mean age was 24 years (SD ± 11.6) with youngest patient of 9 years and oldest one was 70 years old. Negative Appendectomy rate was 8.3%(n = 11). RIPASA score was superior to AIR and Alvarado score in Sensitivity, NLR, Accuracy and Area under the Curve. AIR score performed better in specificity, NPV, PLR compared to RIPASA and Alvarado score. Conclusion: RIPASA score is an overall better scoring system in diagnosing acute appendicitis in compared to Alvarado and AIR score.
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spelling doaj.art-101d1e83951243198d273cd9a4abea0a2023-02-03T05:00:10ZengElsevierHeliyon2405-84402023-01-0191e13013Comparison of Alvarado score, appendicitis inflammatory response score (AIR) and Raja Isteri Pengiran Anak Saleha appendicitis (RIPASA) score in predicting acute appendicitisMuhammad Zeb0Sabir Khan Khattak1Maryam Samad2Syed Shayan Shah3Syed Qasim Ali Shah4Abdul Haseeb5Surgical Resident, General Surgery Ward, Hayatabad Medical Complex, Peshawar, KPK, PakistanSurgical Resident, Orthopedic Ward, Hayatabad Medical Complex, Peshawar, KPK, Pakistan; Corresponding author.Surgical Resident, General Surgery Ward, Hayatabad Medical Complex, Peshawar, KPK, PakistanSurgical Resident, General Surgery Ward, Hayatabad Medical Complex, Peshawar, KPK, PakistanSurgical Resident, General Surgery Ward, Hayatabad Medical Complex, Peshawar, KPK, PakistanSurgical Resident, General Surgery Ward, Hayatabad Medical Complex, Peshawar, KPK, PakistanIntroduction: Acute Appendicitis is the most common surgical emergency encountered in emergency departments. To prevent the rate of negative appendectomies, different systems i.e. Alvarado score and Appendicitis Inflammatory Response Score (AIR) scores were used, but their diagnostic accuracy in Asian population is questionable. Raja Isteri Pengiran Anak Saleha (RIPASA) score has showed promising results in the recent literature. The purpose of this study is to compare the efficacy of Alvarado, AIR and RIPASA scores in the diagnosis of acute appendicitis. Methods: Alvarado, AIR and RIPASA scores were prospectively applied to 132 included patients that were admitted with provisional diagnosis of acute appendicitis and then their surgery was performed in General Surgery Unit, Hayatabad Medical Complex Peshawar, Pakistan from 1st January 2022 to 31st July 2022. Final diagnosis was confirmed by histopathology report and scores were correlated with final report. Cut off value of score >7, >5 and >7.5 were set for Alvarado, AIR and RIPASA score, respectively according to previous literature. Statistics analysis was done for all 3 scoring systems on SPSS version 23. Results: Of 132 patients, there were n = 79(59.8%) males and n = 53(40.2%) females. Mean age was 24 years (SD ± 11.6) with youngest patient of 9 years and oldest one was 70 years old. Negative Appendectomy rate was 8.3%(n = 11). RIPASA score was superior to AIR and Alvarado score in Sensitivity, NLR, Accuracy and Area under the Curve. AIR score performed better in specificity, NPV, PLR compared to RIPASA and Alvarado score. Conclusion: RIPASA score is an overall better scoring system in diagnosing acute appendicitis in compared to Alvarado and AIR score.http://www.sciencedirect.com/science/article/pii/S2405844023002207Acute appendicitisAlvarado scoreRIPASAAIRS
spellingShingle Muhammad Zeb
Sabir Khan Khattak
Maryam Samad
Syed Shayan Shah
Syed Qasim Ali Shah
Abdul Haseeb
Comparison of Alvarado score, appendicitis inflammatory response score (AIR) and Raja Isteri Pengiran Anak Saleha appendicitis (RIPASA) score in predicting acute appendicitis
Heliyon
Acute appendicitis
Alvarado score
RIPASA
AIRS
title Comparison of Alvarado score, appendicitis inflammatory response score (AIR) and Raja Isteri Pengiran Anak Saleha appendicitis (RIPASA) score in predicting acute appendicitis
title_full Comparison of Alvarado score, appendicitis inflammatory response score (AIR) and Raja Isteri Pengiran Anak Saleha appendicitis (RIPASA) score in predicting acute appendicitis
title_fullStr Comparison of Alvarado score, appendicitis inflammatory response score (AIR) and Raja Isteri Pengiran Anak Saleha appendicitis (RIPASA) score in predicting acute appendicitis
title_full_unstemmed Comparison of Alvarado score, appendicitis inflammatory response score (AIR) and Raja Isteri Pengiran Anak Saleha appendicitis (RIPASA) score in predicting acute appendicitis
title_short Comparison of Alvarado score, appendicitis inflammatory response score (AIR) and Raja Isteri Pengiran Anak Saleha appendicitis (RIPASA) score in predicting acute appendicitis
title_sort comparison of alvarado score appendicitis inflammatory response score air and raja isteri pengiran anak saleha appendicitis ripasa score in predicting acute appendicitis
topic Acute appendicitis
Alvarado score
RIPASA
AIRS
url http://www.sciencedirect.com/science/article/pii/S2405844023002207
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