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Background: Acute appendicitis is a common surgical emergency, about 100 cases per 100,000
population annually, with a higher incidence in men. Appendicitis is most prevalent during the
second and third decades of life, with a lifetime risk of 8.6% for men and 6.7% for women.
Implementing an easily accessible diagnostic method could significantly improve the diagnosis
of acute appendicitis, particularly in rural areas with limited access to ultrasound, ultimately
reducing mortality and morbidity rates.
Objective: To validate the Raja Isteri Pengiran Anak Saleha Appendicitis (RIPASA) scoring
system in the diagnosis of acute appendicitis in Addis Ababa, Ethiopia.
Methods: A cross-sectional study was conducted at three selected hospitals in Addis Ababa
from Dec 1, 2022 - Mar 31, 2023. A total of 315 patients who were operated for acute
appendicitis were included in the study. Data were analyzed using Statistical Package for Social
Science 23. Sensitivity, specificity, positive predictive value (PPV), and negative predictive
value (NPV) of Raja Isteri Pengiran Anak Saleha Appendicitis score and ultrasound were
calculated. A P-value of <0.05 indicated statistical significance, and a 95% confidence interval
was taken.
Results: Using intraoperative gross examination as a gold standard, the study found that the
RIPASA scoring system had 93.1% sensitivity, 22.2% specificity, 92.7% PPV, 23.1% NPV, and
a diagnostic accuracy rate of 64.4%. Whereas, the calculated sensitivity, specificity, PPV, and
NPV of the ultrasound were 94.4%, 7.4%, 91.6%, and 11.1%, respectively.
Conclusion & recommendation: In our study, RIPASA performed at least as good as
Ultrasound examination when compared to intraoperative findings of patients suspected of acute
appendicitis. In addition to an existing cutoff value, a slightly higher cutoff value (Score > 8),
may have a better clinical utility than a lower cutoff value of 7.5 in our patient population. With
the aid of further studies, RIPASA may be utilized as an alternative to ultrasound in most
instances, such as in rural areas............. Thesis available at Addis Continental Institute of Public Health Library |
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