Fazal Hussain, Misbah Riaz, Nazish Khattak, Nida Mumtaz, Mah Muneer Khan, Rizwan Ahmed Khan.
Diagnostic accuracy of RIPASA scoring system for acute appendicitis in a tertiary care Hospital in Peshawar.
Pak J Surg Jan ;37(3):188-91.

Objective: This study was done to find out the diagnostic accuracy of RIPASA scoring system for acute appendicitis in a tertiary care hospital in Peshawar. Material and Methods: This study was done on 206 consecutive patients presenting to the emergency department with clinical evidence of acute appendicitis over a period of 6 months from July to December 2019. The study was conducted at the department of surgery, MTI Khyber Teaching Hospital, Peshawar. Validity of RIPASA score as a diagnostic test for acute appendicitis was determined by calculating its sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and diagnostic accuracy, using histopathology as gold standard. Results: Out of 206 patients, 107(51.9%) were males and 99(48.1%) were females. The mean age of participants was 23+-6.3 years. A total of 147(86.4%) patients were diagnosed with acute appendicitis on histopathology. Negative appendectomy rate was 13.6%. RIPASA scoring system had a sensitivity of 96.6%, specificity of 92.9%, PPV of 98.9%, NPV of 81.2% and diagnostic accuracy of 96.1% at a cut-off score of 7.5. Conclusion: RIPASA score is a highly sensitive, specific and accurate test for the diagnosis of acute appendicitis and can be utilized in the emergency department where facilities such as ultrasound and CT are posing diagnostic delay.

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