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Evaluation of modifi ed Alvarado scoring system and RIPASA scoring system as diagnostic tools of acute appendicitis

World Journal of Emergency Medicine 2017年第4期8卷 276-280页

作者： Abdullah Shuaib Ali Shuaib zainab fakhra Bader Marafi Khalid Alsharaf Abdullah Behbehani Department of Surgery Kuwait Mubarak Alkabeer Hospital Jabriya Kuwait Biomedical Engineering Unit Physiology Department Faculty of Medicine Kuwait University Kuwait City Kuwait MD in internship year Kuwait Institute of Medical Specialization Kuwait City Kuwait Department of Surgery Faculty of Medicine Kuwait University Kuwait City Kuwait

BACKGROUND: Acute appendicitis is the most common surgical condition presented in emergency departments worldwide. Clinical scoring systems, such as the Alvarado and modified Alvarado scoring systems, were developed with the goal of reducing the negative appendectomy rate to 5%–10%. The Raja Isteri Pengiran Anak Saleha Appendicitis(RIPASA) scoring system was established in 2008 specif ically for Asian populations. The aim of this study was to compare the modif ied Alvarado with the RIPASA scoring system in Kuwait ***: This study included 180 patients who underwent appendectomies and were documented as having "acute appendicitis" or "abdominal pain" in the operating theatre logbook(unit B) from November 2014 to March 2016. The sensitivity, specificity, positive predictive value(PPV), negative predictive value(NPV), diagnostic accuracy, predicted negative appendectomy and receiver operating characteristic(ROC) curve of the modified Alvarado and RIPASA scoring systems were derived using SPSS statistical ***: A total of 136 patients were included in this study according to our criteria. The cut-off threshold point of the modif ied Alvarado score was set at 7.0, which yielded a sensitivity of 82.8% and a specif icity of 56%. The PPV was 89.3% and the NPV was 42.4%. The cut-off threshold point of the RIPASA score was set at 7.5, which yielded a 94.5% sensitivity and an 88% specif icity. The PPV was 97.2% and the NPV was 78.5%. The predicted negative appendectomy rates were 10.7% and 2.2% for the modif ied Alvarado and RIPASA scoring systems, respectively. The negative appendectomy rate decreased significantly, from 18.4% to 10.7% for the modified Alvarado, and to 2.2% for the RIPASA scoring system, which was a signif icant difference(P<0.001) for both scoring ***: Based on the results of this study, the RIPASA score is a simple scoring system with better sensitivity and specif icity than the modif ied Alvarado scoring system in A

关键词： Acute appendicitis Modifi ed Alvarado score RIPASA score

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