الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Background: Acute appendicitis is the most common indication for emergency surgery worldwide, with incidence of 1.17 per 1000 and lifetime risk of 8.6% in men and 6.7% in women. The incidence is highest in adolescents and young adults, but the incidence of complicated appendicitis shows little variance between different age groups. RIPASA score is a more extensive yet simple additive scoring system consisting of 14 fixed parameters and an additional parameter (NRIC) that is unique to our population setting. All these 15 parameters are easily obtainable from a good clinical history, examination and investigation. Alvarado scoring system, which is based on histopathology, physical examination, and a few laboratory investigations and is very easy to apply but , falls disappointingly short of expectations in females, especially of child-bearing age, reporting a negative appendectomy rate of 30% in females. The aim of the work: to determine the usefulness and efficacy of RIPASA score versus Alvarado score in providing the diagnosis of acute appendicitis and decreasing the rate of unnecessary (negative) appendectomy. Patients: One hundred and fifty patients (n = 150) who were initially diagnosed as acute appendicitis in the period between June 2017 to May 2018. Methods: All cases were subjected to complete history taking, thorough physical examination, and routine preoperative investigations. Moreover, both Alvarado and RIPASA scores were calculated for every case. Results: On assessment of RIPASA score, it had a sensitivity of 97.1 % and a specificity of 93.75 %. Moreover, its diagnostic accuracy was estimated to be 96.7%. Regarding Alvarado score, the sensitivity was 77.6 % whereas specificity was 62.5%. Furthermore, its accuracy was estimated to be 76%. RIPASA score had a significantly higher sensitivity and specificity (p < 0.001). Moreover, the accuracy and the NPV revealed high statistically significant difference between the two groups (p < 0.001), but the PPV showed no significant difference between the two groups (p = 0.148). Conclusion: Based on the results of our study, RIPASA score was found to be superior to Alvarado score regarding its sensitivity, specificity, and diagnostic accuracy of acute appendicitis patients. Recommendations: Routine integration of RIPASA score beside clinical examination in the evaluation of suspected cases with acute appendicitis in the emergency departments.