Evaluation of RIPASA Score with Adding C-Reactive Protein (CRP) in Diagnosis of Acute Appendicitis. | ||
| The Egyptian Journal of Surgery | ||
| Volume 44, Issue 3, July 2025, Pages 828-834 PDF (423.61 K) | ||
| Document Type: Original Article | ||
| DOI: 10.21608/ejsur.2024.338571.1293 | ||
| Authors | ||
| M. Ashraf Balbaa; Seham Fathy Attia Dawoud* ; Mahmoud Ahmed Shahin; Naglaa Fathy Amer | ||
| Department of General Surgery, Faculty of Medicine, Menoufia University, Egypt | ||
| Abstract | ||
| Background: Diagnosing acute appendicitis can be challenging, and clinical scoring systems like the RIPASA score can assist physicians in making an accurate diagnosis and reducing the risk of negative appendectomies. Incorporating CRP as a laboratory adjunct may enhance the diagnostic accuracy of the RIPASA score. Objectives: To assess the effectiveness of the RIPASA score when C-reactive protein (CRP) is added to it in acute appendicitis diagnosis. Patients and Methods: Seventy non-consecutive patients who arrived to Menoufia University Hospital's emergency room between May 2022 and October 2023 with lower abdomen pain on the right side and probable acute appendicitis were the subjects of this cross-sectional observational research. Demographic information, complaints, prior medical history, general and local examinations, and laboratory tests, including CRP, were evaluated for each case. Comparison between the final histopathological diagnosis and the performance of the RIPASA score with the inclusion of CRP. Results: Of the seventy cases, thirty were female and forty were male. The average age of the patients under study was 30.03±27.54. The RIPASA score demonstrated a sensitivity of 84.3%, specificity of 74%, PPV of 90%, NPV of 64%, and accuracy of 81% in diagnosing acute appendicitis at a cutoff point of 8.5. With a cutoff point of 9.5 with the inclusion of CRP, the modified RIPASA showed 86.3% sensitivity, 73.7% specificity, 90% PPV, 67% NPV, and 83% accuracy in diagnosing acute appendicitis. Conclusion: Adding CRP to RIPASA score improves its accuracy as a good diagnostic tool for acute appendicitis. | ||
| Keywords | ||
| Acute appendicitis; Clinical scoring; C-reactive protein; RIPASA | ||
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