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15. Diagnostic Accuracy of RIPA-SA Score in Detecting Acute Appendicitis
Hunain1, Uzma1 and Saif Ur Rahman2
ABSTRACT
Objective: Determining the sensitivity and specificity of the RIPA-SA score is the main goal in evaluating its diagnostic accuracy in identifying acute appendicitis. Specificity evaluates the score's capacity to accurately identify real negatives, offering vital information about its clinical relevance, while sensitivity evaluates the score's capacity to properly detect true positives.
Study Design: A cross-sectional study
Place and Duration of Study: This study was conducted at the Department of General Surgery, Saidu Group of Teaching Hospital and Swat Medical Complex, Swat from January 2022 to December 2022.
Methods: Between January 2022 and December 2022, 224 acute appendicitis patients at the General Surgery Department of the Saidu Group of Teaching Hospital and the Swat Medical Complex in Swat participated in a cross-sectional research. Patients who had discomfort in the right iliac fossa (RIF) for less than seven days were recruited. Taking into account the surgical team's experience as well as imaging results, surgeons evaluated the surgical propensities of their patients. After the RIPA-SA score was assessed, scores based on fifteen distinct factors were produced. Based on the Receiver Operating Characteristic (ROC) study, the ideal cut-off threshold score was found to be 7.5.
Results: The overall mean age was 26.4 ± 8.98 years. Age-wise distribution of patients were as follows; 146 (65.2%) in 10-20 years, 36 (16.1%) in 21-30 years, 28 (12.5%) in 31-40 years and 14 (6.3%) in 41-50 years. Of the total 224 patients, there were 140 (62.5%) male and 84 (37.5%) female. Histopathology confirmed 128 positive cases of acute appendicitis, while the RIPA-SA score diagnosed 133 cases. There were 102 true negatives, 5 false negatives, 125 real positives, and 8 false positives among them. A 96.1% sensitivity, 92.7% specificity, 94.7% diagnostic accuracy, 94.0% positive-predictive-value, and 95.3% negative-predictive-value were all shown by the RIPA-SA score.
Conclusion: The present study indicated that the RIPA-SA score exhibited effective proficiency in identifying cases of acute appendicitis. Nevertheless, it achieves a balance by identifying cases early, thereby mitigating the risk of potential complications.
Key Words: Acute appendicitis, diagnostic accuracy, RIPA-SA score