RIPASA评分相对于阿尔瓦拉多评分在诊断急性阑尾炎中的敏感性、特异性和可靠性
Sensitivity, Specificity and Reliability of the RIPASA Score for Diagnosis of Acute Appendicitis in Relation to the Alvarado Score.
作者信息
Arroyo-Rangel Celerino, Limón Iván O, Vera Ángel G, Guardiola Pedro M, Sánchez-Valdivieso Enrique A
机构信息
Departamento de Cirugía, Hospital de Alta Especialidad de Veracruz, Secretaría de Salud, Veracruz, México.
Departamento de Cirugía, Hospital de Alta Especialidad de Veracruz, Secretaría de Salud, Veracruz, México; Departamento de Investigación, Escuela de Medicina, Universidad Cristóbal Colón, Campus Calasanz, Boca del Río, México.
出版信息
Cir Esp (Engl Ed). 2018 Mar;96(3):149-154. doi: 10.1016/j.ciresp.2017.11.013. Epub 2018 Feb 24.
INTRODUCTION
In order to avoid delay in the diagnosis of acute appendicitis and reduce the margin of error, the use of scales has been used. The aim of this study was to compare the effectiveness of the Alvarado and RIPASA scores in the clinical diagnosis of acute appendicitis and to correlate with the histopathological results.
METHODS
Prospective, longitudinal, analytical, comparative and observational study. Patients with abdominal pain syndrome suggestive of acute appendicitis and submitted to surgical intervention were included; the Alvarado and RIPASA scores were simultaneously applied. The pathology report was obtained and the efficacy of both scores for the diagnosis of acute appendicitis was compared.
RESULTS
One hundred patients were included. It was shown that the RIPASA score demonstrated greater diagnostic accuracy compared to the Alvarado score, with sensitivity of 98,8% and specificity of 71,4% versus 90,7% and 64,3%, respectively. The RIPASA score showed an area under the curve of 0,88 and the Alvarado scale of 0,80.
CONCLUSIONS
The RIPASA score is a more specific, convenient and accurate system than the Alvarado score for the Mexican population.
引言
为避免急性阑尾炎诊断延误并减少误差范围，人们使用了评分系统。本研究旨在比较阿尔瓦拉多（Alvarado）评分和RIPASA评分在急性阑尾炎临床诊断中的有效性，并与组织病理学结果相关联。
方法
前瞻性、纵向、分析性、比较性和观察性研究。纳入有提示急性阑尾炎的腹痛综合征且接受手术干预的患者；同时应用阿尔瓦拉多评分和RIPASA评分。获取病理报告并比较两种评分对急性阑尾炎诊断的有效性。
结果
纳入100例患者。结果显示，与阿尔瓦拉多评分相比，RIPASA评分具有更高的诊断准确性，其敏感性为98.8%，特异性为71.4%，而阿尔瓦拉多评分的敏感性和特异性分别为90.7%和64.3%。RIPASA评分的曲线下面积为0.88，阿尔瓦拉多评分为0.80。
结论
对于墨西哥人群，RIPASA评分是比阿尔瓦拉多评分更特异、便捷和准确的系统。
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