Performance of RIPASA and AIR scores in an Egyptian subset of patients with suspected diagnosis of acute Appendicitis

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Abstract Background Early and definitive acute appendicitis (AA) diagnosis remains a great challenge in clinical practice worldwide. Currently, several risk scores are available for the clinical assessment of AA, although there are differences in their accuracy rates. Aim To assess and analyze the accuracy of the acute inflammatory response (AIR) and Raja Isteri Pengiran Anak Saleha Appendicitis (RIPASA) scores in an Egyptian population. Methods A series of 310 patients, 61% male with a median age of 18 years, with Rt. Iliac fossa pain were clinically evaluated for suspicion of AA. All patients were assessed using both the AIR and RIPASA scores. Following evaluation, all patients underwent appendectomy. A final diagnosis of AA was based on histopathology. Two predetermined cutoff values for the AIR score and one cutoff value for the RIPASA score was evaluated for sensitivity, specificity, and accuracy. Results The sensitivities of the RIPASA score cutoff value of ≥7.5 and AIR score cutoff values of >4 and >8 were 83.8%, 92.2%, and 33.1%, accordingly, while the specificities were 69.2%, 76.7%, and 84.6%, respectively. AIR score of >4 (91%) was more accurate compared to AIR score of >8 (37.4%) and RIPASA score of ≥7.5 (82.5%). Conclusion An AIR score of >4 had better sensitivity, specificity, and accuracy compared to a RIPASA score of ≥7.5 for the Egyptian population. However, an AIR score of >8 was more specific.

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