None listed
Conditions
Brief summary
Absolute diagnosis of acute appendicitis is only possible with histopathology results after appendectomy. On the other hand, the decision to perform surgery is based solely on clinical evaluation supplemented by laboratory data. Therefore diagnostic errors are common, resulting in a median incidence of perforation of 20% and a negative laparotomy rate ranging from 2% to 30%. So aim of our study is to compare Modified Alvarado score versus RIPASA score in diagnosing acute appendicitis among middle eastern population in Aseer region (southern region of Saudi Arabia).
Interventions
Both modified Alvarado and RIPASA scores will be fulfilled by the research team for patients who are going to be operated for acute appendicitis in the preoperative period.
Modified Alvarado Score
Symptoms
Migration of pain to the right lower quadrant 1
Anorexia 1
Nausea/Vomiting 1
Signs
Tenderness in the right iliac fossa 2
Rebound tenderness in the right iliac fossa 1
Elevated temperature (>37,3 degrees Centigrade) 1
Investigations
Leukocytosis (>10.000/ml) 2
Total
Both modified Alvarado and RIPASA scores will be fulfilled by the research team for patients who are going to be operated for acute appendicitis in the preoperative period. Modified Alvarado Score Symptoms Migration of pain to the right lower quadrant 1 Anorexia 1 Nausea/Vomiting 1 Signs Tenderness in the right iliac fossa 2 Rebound tenderness in the right iliac fossa 1 Elevated temperature (>37,3 degrees Centigrade) 1 Investigations Leukocytosis (>10.000/ml) 2 Total RIPASA Demographic data Male 1.0 Female 0.5 Age < 39.9 years 1.0 Age greater than or equal 40 years 0.5 Symptoms RIF pain 0.5 Migration of RQP 0.5 Anorexia 1.0 Nausea / Vomiting 1.0 Duration of Symptoms < 48 hrs 1.0 Duration of Symptoms > 48 hrs 0.5 Signs RIF tenderness 1.0 RIF guarding 2.0 Rebound tenderness 1.0 Rovsing’s sign 2.0 Fever >37 - < 39 degrees Centigrade 1.0 Investigations Raised WBCs 1.0 Negative Urinalysis 1.0 Additional scores Foreign ID 1.0 Total Both scores will be calculated for each patient by summation of the points of positive finding, then sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) for both scoring systems will be calculated.
Sponsors
King Khalid University
Study design
Allocation
Non-randomised trial
Intervention model
Single group
Primary purpose
Diagnosis
Masking
Open (masking not used)
Eligibility
Sex/Gender
All
Age
13 Years to No maximum
Healthy volunteers
No
Inclusion criteria
All patients older than 13 years who will undergo appendectomy will be included in the study.
Exclusion criteria
Patients below 13 years are treated by the pediatric team according to the policy of our hospital and will be excluded from the study.
Outcome results
None listed