Department of Emergency and General Practice, National Academy of Medical Sciences, Kathmandu, Nepal.
Department of Emergency and General Practice, Patan Academy of Health Sciences, Lalitpur, Nepal.
J Nepal Health Res Counc. 2021 Apr 23;19(1):111-114. doi: 10.33314/jnhrc.v19i1.1435.
Acute Appendicitis is a clinical diagnosis with atypical presentation in young, elderly, females, genitourinary and gynecological conditions. Delayed appendectomy increases the risk of appendicular perforation, sepsis morbidity and mortality. Literature reports as high as 20-40% negative appendectomy. Raja Isteri Pengiran Anak Saleha score has come with higher sensitivity and diagnostic accuracy than Alvarado score in Asian population. This study aims to compare RIPASA and Alvarado score for diagnostic accuracy.
Appendectomy patients at Patan Hospital from April to September 2014 were compared on raja isteri pengiran anak saleha (cut-off value 7.5 out of 15) and Alvarado score (cut-off value 7 out of 10). Final diagnosis was histopathology based. Microsoft Excel and SPSS 17 were used for analysing sensitivity, specificity and diagnostic accuracy of both scores. The study included patients who underwent appendectomy with histopathology report and excluded those with conservative management, generalized peritonitis, appendicular lump and abscess.
There were 88 appendectomy patients with median age 26 (18.25, 35) years, and male 52 (59.1%). Negative appendectomy was 10 (11.36%). Sensitivity and specificity of Raja Isteri Pengiran Anak Saleha 98.71% and 80.00% respectively, and for Alvarado 52.56% and 70%.The Raja Isteri Pengiran Anak Saleha score had statistically significant sensitivity (p=0.000). Positive Predictive value, Negative Predictive Value and diagnostic accuracy were 97.46%, 88.89% and 96.6% for RIPASA and 93.18%, 15.19% and 54.4% for Alvarado respectively.
The Raja Isteri Pengiran Anak Saleha score had better diagnostic accuracy compared to Alvarado score for diagnosis of Acute Appendicitis.
急性阑尾炎是一种临床表现不典型的疾病，在年轻人、老年人、女性、泌尿生殖系统和妇科疾病中更为常见。延迟阑尾切除术会增加阑尾穿孔、脓毒症发病率和死亡率的风险。文献报道阑尾切除术的阴性率高达 20-40%。在亚洲人群中，Raja Isteri Pengiran Anak Saleha 评分的敏感性和诊断准确性均高于 Alvarado 评分。本研究旨在比较 RIPASA 和 Alvarado 评分在诊断准确性方面的差异。
比较 2014 年 4 月至 9 月在帕坦医院接受阑尾切除术的患者的 Raja Isteri Pengiran Anak Saleha（截断值为 15 分中的 7.5 分）和 Alvarado 评分（截断值为 10 分中的 7 分）。最终诊断基于组织病理学。使用 Microsoft Excel 和 SPSS 17 分析两种评分的敏感性、特异性和诊断准确性。本研究纳入了接受阑尾切除术并伴有组织病理学报告的患者，排除了接受保守治疗、弥漫性腹膜炎、阑尾肿块和脓肿的患者。
共纳入 88 例阑尾切除术患者，中位年龄为 26（18.25，35）岁，男性 52 例（59.1%）。阴性阑尾切除术 10 例（11.36%）。Raja Isteri Pengiran Anak Saleha 的敏感性和特异性分别为 98.71%和 80.00%，而 Alvarado 的敏感性和特异性分别为 52.56%和 70%。Raja Isteri Pengiran Anak Saleha 评分的敏感性具有统计学意义（p=0.000）。RIPASA 的阳性预测值、阴性预测值和诊断准确性分别为 97.46%、88.89%和 96.6%，Alvarado 的阳性预测值、阴性预测值和诊断准确性分别为 93.18%、15.19%和 54.4%。
与 Alvarado 评分相比，Raja Isteri Pengiran Anak Saleha 评分在诊断急性阑尾炎方面具有更高的诊断准确性。
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