الفهرس 
? Anatomy of the AppendixOnly 14 pages are availabe for public view
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Abstract
Background: Acute appendicitis is the most common surgical condition presented in emergency departments worldwide. It is also the most common cause of abdominal pain requiring surgery, with a lifetime risk of 7%.
Objectives: The aim of this study is to compare between diagnostic accuracy of RIPASA score and Alvarado score in the diagnosis of acute appendicitis.
Patients and Methods: This randomized prospective study was carried out on 100 patients complaining of acute abdominal pain diagnosed as appendicitis undergoing open or laparoscopic appendectomy operation in the general surgery department of Mataria Teaching Hospital (MTH), from February 2020 to August 2020. Clinical examination and laboratory workup were done to the population of the study according to the scoring systems (ALVARADO and RIPASA scoring systems). Scoring was documented to every patient in the study preoperatively. The decision to operate was made by the senior surgeon (consultant), based on clinical and laboratory findings not depending on the results of the scoring systems. All patients received information about surgical technique and risks of the operation and other options for treatment. All patients were participated these study after providing informed consent and the study was approved by the ethical committee of Ain Shams University.
Results: In our study we found that Ribasa score was more sensitivity (100% Vs 95%) respectively and Alvarado score was more specificity (38% Vs 0%) respectively. The Positive Predictive Value (PPV) for Alvarado score is significantly higher than that of score RIPASA (89% Vs 84%) respectively. The Negative Predictive Value (PPV) for Alvarado score is significantly higher than that of RIPASA score (60 Vs 0%) respectively. In our study by using ROC the area under the curve of ALVARADO score is 0.924 which is greater than that for RIPASA scoring, which is 0.918. The difference in the area under the curves of 0.6% is significant between two scoring systems. The P-value for these two variables in both the scores is <0.001, which shows there is significant association between these values. Although previous studies by Arroyo et al and Pasumarthi and Madhu found that the area under the curve of RIPASA scoring greater than that for ALVARADO score with P-value <0.001 also.
Conclusion: Alvarado score was more specificity, RIPASA scores was more sensitivity. Alvarado score is shown to have a better diagnostic accuracy than RIPASA score. More trials with more number of patients need to conduct to reach ideal score in diagnosis of Acute Appendicitis.