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Research Article
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Year 2020, Volume: 42 Issue: 4, 500 - 506, 31.12.2020

Mine Esmer Gökçe , İlhan Korkmaz , Yusuf Tekin , Sefa Yurtbay Erdal Demirtaş , Orhan Özsoy , Sedat Özbay , Fatma Kukul Güven

https://doi.org/10.7197/cmj.828748

Abstract

References

  • REFERENCES: 1) Anderson KD, Parry RL, O’Neill JA, Rowe MI, Grosfeld JL, Fonkalsrud EW, Coran AG. Pediatric surgery Mosby-Year Book. 1998; 1369-1379.
  • 2) Cev M, Bozfakioğlu Y, Değerli Ü. Apendiks hastalıkları. Cerrahi gastroenteroloji İstanbul Nobel Tıp Kitapevi 1989; 258-73.
  • 3) Flum DR, Koepsell T. The clinical and economic correlates of misdiagnosed appendicitis. Arch Surg 2002; 137: 799-804. 4) Baachman LM, Bischof DB, Bischofberger SA, Bonani MG, Osann FM, Steurer J. Systematic quantitative overviews of the literatüre to determine the value of diagnostic tests for predicting acute apendicitis. BMC Surg 2002; 21: 2.
  • 5) Reilly BM, Evans AT: Translating clinical research into clinical practice: impact of using prediction rules to make decisions. Ann Intern Med 2006, 144: 201-209.
  • 6) Anderson RE. Meta-analysis of the clincal and laboratory diagnosis of appendicitis. Br. J Surg 2004; 91: 28-37.
  • 7) Pouget-Baudry Y, Mucci S, Eyssartier E, et al. The use of the Alvarado score in the management of right lower quadrant abdominal pain in the adult. J Visc Surg 2010; 147: 40-44.
  • 8) Lintula H, Pesonen E, Kokki H, Vanamo K, eskelinen M. A diagnostic score for children with suspected appendicitis. Langenbecks Arch Surg 2005; 390: 164-70.
  • 9) Chong CF, Adi MI, Thien A, et al. Development of the RİPASA score: a new appendicitis scoring system for the diagnosis of acute appendicitis. Singapore Med J 2010; 51: 220-5.
  • 10) Alnjadat I., Abdallah B. Alvarado versus RİPASA score in diagnosing acute appendicitis. Rawal Medical Journal. 2013;38(2):147-151.
  • 11) Nanjundaiah N., Ashfaque Mohammed, Venkatesh Shanbhag, Kalpana Ashfaque, Priya S. A. A Comparative Study of RIPASA Score and ALVARADO Score in the Diagnosis of Acute Appendicitis. Journal of Clinical and Diagnostic Research. 2014;8(11):NC03-5.
  • 12) Karami M.Y., Niakan H., Zadebagheri N., Mardani P., Shayan Z., Deilami I. Which One is Better? Comparison of the Acute Inflammatory Response, Raja Isteri Pengiran Anak Saleha Appendicitis and Alvarado Scoring Systems. Ann Coloproctol. 2017; 33(6):227–31.
  • 13) Pasumarthi V, Madhu CP. A comparative study of RIPASA score and ALVARADO score in diagnosis of acute appendicitis. Int Surg J. 2018;5(3):796-801.
  • 14) Frountzasa M., Stergiosa K., Kopsinia D., Schizasb D., Kontzoglouc K., Toutouzasd K. Alvarado or RIPASA score for diagnosis of acute appendicitis? A meta-analysis of randomized trials. International Journal of Surgery 2018;56: 307–314.
  • 15) Regar M.K, Choudhary G.S, Nogia C, Pipal D.K, Agrawal A., Srivastava H. Comparison of Alvarado and RIPASA scoring systems in diagnosis of acute appendicitis and correlation with intraoperative and histopathological findings. Int Surg J. 2017;4(5):1755-61.
  • 16) Rodrigues W, Sindhu S. Diagnostic Importance of Alvarado and RIPASA Score in Acute Appendicitis. International Journal of Scientific Study. 2017; 4(11):57-60.
  • 17) Arroyo-Rangel C., Limon I.O., Vera A.G., Guardiola P.M., Sanchez-Valdivieso E.A. Sensitivity, Specificity and Reliability of the RIPASA Score for Diagnosis of Acute Appendicitis in Relation to the Alvarado Score. Cir Esp.2018;96(3):149-54.

Comparison of alvarado and ripasa scores in patients with acute appendicitis

Year 2020, Volume: 42 Issue: 4, 500 - 506, 31.12.2020

Mine Esmer Gökçe , İlhan Korkmaz , Yusuf Tekin , Sefa Yurtbay Erdal Demirtaş , Orhan Özsoy , Sedat Özbay , Fatma Kukul Güven

https://doi.org/10.7197/cmj.828748

Abstract

Objective: Acute appendicitis management delays results in perforation and increases the morbidity and mortality. Studies have reported a 20% perforation rate, and 2-30% negative laparotomy whose diagnoses are made by symptoms and physical examination. By using anamnesis, clinical signs-symptoms and inflammatory parameters to reduce the diagnosis time, complications, and morbidity-mortality of AA, various scoring methods have been developed. The first scoring system defined for this purpose is Alvarado scoring system. The RIPASA scoring system was developed for patients in Asia. In this study, we aimed to determine which scoring is more suitable for our population by comparing Alvarado and RIPASA scoring methods in patients who underwent an appendectomy.
Method: The Alvarado and RIPASA scores of each patient were calculated by the scoring system parameters after the 182 patient files were analyzed retrospectively. At cut-off value of 7.5 for RIPASA score and 7 for Alvarado score, patients were divided into high and low-risk groups. The positive predictive value, negative predictive value, sensitivity, and specificity were calculated and the two scoring systems' effectivity were compared with Chi-square and area under curve analysis.
Results: According to the histological examination 42(23%) patients were not considered as acute appendicitis. RİPASA scoring systems high-risk group classification was better by predicting the acute appendicitis patients (p = 0.001, p <0.05). The area under the curve for RIPASA score calculated as 0.738 and this is statistically significant (p = 0.001; p <0.05). The result was better then the Alvarado AUC score (0,633). Alvarado scoring systems' negative predictive value was higher than the RİPASA score, respectively (58,14%, 32.56%).
Conclusions: It is beneficial to use the RIPASA scoring system for patients in our region to reduce the rate of negative laparotomy and unnecessary surgical procedures in patients admitted to emergency services with the suspicion of acute appendicitis.

Keywords

acute appendicitis RİPASA SCORE ALVARADO SCORE

References

  • REFERENCES: 1) Anderson KD, Parry RL, O’Neill JA, Rowe MI, Grosfeld JL, Fonkalsrud EW, Coran AG. Pediatric surgery Mosby-Year Book. 1998; 1369-1379.
  • 2) Cev M, Bozfakioğlu Y, Değerli Ü. Apendiks hastalıkları. Cerrahi gastroenteroloji İstanbul Nobel Tıp Kitapevi 1989; 258-73.
  • 3) Flum DR, Koepsell T. The clinical and economic correlates of misdiagnosed appendicitis. Arch Surg 2002; 137: 799-804. 4) Baachman LM, Bischof DB, Bischofberger SA, Bonani MG, Osann FM, Steurer J. Systematic quantitative overviews of the literatüre to determine the value of diagnostic tests for predicting acute apendicitis. BMC Surg 2002; 21: 2.
  • 5) Reilly BM, Evans AT: Translating clinical research into clinical practice: impact of using prediction rules to make decisions. Ann Intern Med 2006, 144: 201-209.
  • 6) Anderson RE. Meta-analysis of the clincal and laboratory diagnosis of appendicitis. Br. J Surg 2004; 91: 28-37.
  • 7) Pouget-Baudry Y, Mucci S, Eyssartier E, et al. The use of the Alvarado score in the management of right lower quadrant abdominal pain in the adult. J Visc Surg 2010; 147: 40-44.
  • 8) Lintula H, Pesonen E, Kokki H, Vanamo K, eskelinen M. A diagnostic score for children with suspected appendicitis. Langenbecks Arch Surg 2005; 390: 164-70.
  • 9) Chong CF, Adi MI, Thien A, et al. Development of the RİPASA score: a new appendicitis scoring system for the diagnosis of acute appendicitis. Singapore Med J 2010; 51: 220-5.
  • 10) Alnjadat I., Abdallah B. Alvarado versus RİPASA score in diagnosing acute appendicitis. Rawal Medical Journal. 2013;38(2):147-151.
  • 11) Nanjundaiah N., Ashfaque Mohammed, Venkatesh Shanbhag, Kalpana Ashfaque, Priya S. A. A Comparative Study of RIPASA Score and ALVARADO Score in the Diagnosis of Acute Appendicitis. Journal of Clinical and Diagnostic Research. 2014;8(11):NC03-5.
  • 12) Karami M.Y., Niakan H., Zadebagheri N., Mardani P., Shayan Z., Deilami I. Which One is Better? Comparison of the Acute Inflammatory Response, Raja Isteri Pengiran Anak Saleha Appendicitis and Alvarado Scoring Systems. Ann Coloproctol. 2017; 33(6):227–31.
  • 13) Pasumarthi V, Madhu CP. A comparative study of RIPASA score and ALVARADO score in diagnosis of acute appendicitis. Int Surg J. 2018;5(3):796-801.
  • 14) Frountzasa M., Stergiosa K., Kopsinia D., Schizasb D., Kontzoglouc K., Toutouzasd K. Alvarado or RIPASA score for diagnosis of acute appendicitis? A meta-analysis of randomized trials. International Journal of Surgery 2018;56: 307–314.
  • 15) Regar M.K, Choudhary G.S, Nogia C, Pipal D.K, Agrawal A., Srivastava H. Comparison of Alvarado and RIPASA scoring systems in diagnosis of acute appendicitis and correlation with intraoperative and histopathological findings. Int Surg J. 2017;4(5):1755-61.
  • 16) Rodrigues W, Sindhu S. Diagnostic Importance of Alvarado and RIPASA Score in Acute Appendicitis. International Journal of Scientific Study. 2017; 4(11):57-60.
  • 17) Arroyo-Rangel C., Limon I.O., Vera A.G., Guardiola P.M., Sanchez-Valdivieso E.A. Sensitivity, Specificity and Reliability of the RIPASA Score for Diagnosis of Acute Appendicitis in Relation to the Alvarado Score. Cir Esp.2018;96(3):149-54.
There are 16 citations in total.

Details

Primary Language English
Subjects Health Care Administration
Journal Section Surgical Science Research Articles
Authors

Mine Esmer Gökçe 0000-0002-1354-2453

İlhan Korkmaz 0000-0001-5182-3136

Yusuf Tekin 0000-0001-8047-4836

Sefa Yurtbay 0000-0002-7373-1002

Erdal Demirtaş 0000-0003-0853-0623

Orhan Özsoy 0000-0001-7623-504X

Sedat Özbay 0000-0002-7373-1002

Fatma Kukul Güven 0000-0003-3755-6021

Publication Date December 31, 2020
Acceptance Date December 21, 2020
Published in Issue Year 2020 Volume: 42 Issue: 4

Cite

AMA Esmer Gökçe M, Korkmaz İ, Tekin Y, et al. Comparison of alvarado and ripasa scores in patients with acute appendicitis. CMJ. December 2020;42(4):500-506. doi:10.7197/cmj.828748