Evaluation of RIPASA Score with Adding C-Reactive Protein (CRP) in Diagnosis of Acute Appendicitis.

Document Type : Original Article

Authors

Department of General Surgery, Faculty of Medicine, Menoufia University, Egypt

Abstract

Background: Diagnosing acute appendicitis can be challenging, and clinical scoring systems like the RIPASA score can
assist physicians in making an accurate diagnosis and reducing the risk of negative appendectomies. Incorporating CRP
as a laboratory adjunct may enhance the diagnostic accuracy of the RIPASA score.
Objectives: To assess the effectiveness of the RIPASA score when C-reactive protein (CRP) is added to it in acute
appendicitis diagnosis.
Patients and Methods: Seventy non-consecutive patients who arrived to Menoufia University Hospital's emergency
room between May 2022 and October 2023 with lower abdomen pain on the right side and probable acute appendicitis
were the subjects of this cross-sectional observational research. Demographic information, complaints, prior medical
history, general and local examinations, and laboratory tests, including CRP, were evaluated for each case. Comparison
between the final histopathological diagnosis and the performance of the RIPASA score with the inclusion of CRP.
Results: Of the seventy cases, thirty were female and forty were male. The average age of the patients under study was
30.03±27.54. The RIPASA score demonstrated a sensitivity of 84.3%, specificity of 74%, PPV of 90%, NPV of 64%, and
accuracy of 81% in diagnosing acute appendicitis at a cutoff point of 8.5. With a cutoff point of 9.5 with the inclusion
of CRP, the modified RIPASA showed 86.3% sensitivity, 73.7% specificity, 90% PPV, 67% NPV, and 83% accuracy in
diagnosing acute appendicitis.
Conclusion: Adding CRP to RIPASA score improves its accuracy as a good diagnostic tool for acute appendicitis.

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