A prospective study of comparative analysis of the accuracy of modified alvarado, lintula, ohmann, ripasa and tzanakis scores in diagnosis of acute appendicitis

Research Article
Kashish Arora*, J G Bhatt, Jignesh Dave, Jayendra Vagadiya, and Purohit Naresh Kumar
General surgery
Tzanakis, Ripasa, Ohmann, Lintula, Modidfied Alvarado

Introduction: Acute appendicitis is still one of the common diseases in surgical practice. But most of the time appendicitis does not have its classical presentation. So the diagnosis of atypical presentation is challenging. This study aimed to compare the accuracy of Modified Alvarado, LINTULA, Ohmann, Raja Isteri Pengiran Anak Saleha (RIPASA), and Tzanakis scores in predicting the need for appendectomy in Acute Appendicitis patients. Methods: This Analytical study conducted at PDU Medical College and Hospital, Rajkot, Gujarat for a period of 2 years, from year 2020 to 2022, with Sample size of 230 patients, with the mean age of 29 +/- 9.7 years, who were admitted in surgery department. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), diagnostic accuracy, predicted negative appendectomy and receiver operating characteristic (ROC) curve of Modified Alvarado, LINTULA, Ohmann, Raja Isteri Pengiran Anak Saleha (RIPASA), and Tzanakis scores were evaluated and compared. Statistical analysis was done with p<0.05 was considered to be significant. Results: The diagnosis was histopathologically confirmed in 199 cases (86.5%). The area under the curve (AUC), sensitivity, and specificity of RIPASA score in the cut-off value of 7.5 were 0.98, 97.98%, and 90.32%, respectively. RIPASA scoring system had the best screening performance in detection of cases with Appendicitis as compared to other scoring systems, as per our study. Conclusion: RIPASA score is more sensitive and specific than Modified Alvarado, Tzanakis, LINTULA and Ohmann scores in diagnosing Acute appendicitis patients needing appendectomy.