A COMPARATIVE STUDY OF A NOVEL PREOPERATIVE COMPLICATED ACUTE APPENDICITIS SCORING SYSTEM AND RIPASA SCORING SYSTEM IN PREDICTION OF COMPLICATED ACUTE APPENDICITIS

Abstract

Background: A study was carried out to assess accuracy rates of two scoring systems—the RIPASA scoring system and the Novel Preoperative Complicated Appendicitis Score— in identifying patients who had undergone surgery for acute appendicitis (AA) and had complex appendicitis. Methods: A prospective comparative observational study was carried out among patients admitted with acute appendicitis in the General Surgery department of the RL Jalappa Hospital and Research Center. In all, 72 AA individuals were involved in this study. The IEC granted clearance for this study's ethical committee. Detailed history of the participants followed by clinically examination was done by principal investigator post which diagnosis of AA was made. The Novel Preoperative Complicated Acute Appendicitis Score and RIPASA Score were assessed in all cases to predict complicated appendicitis. Results: In the present study Mean age of participants was 34.6 years with female predominance. 75% of the cases presented with diffuse pain abdomen, 68.1% of cases presented with RIF pain, migrating to RIF in 86.1% of the cases, and nausea / vomiting in 45.8% of the cases. Also, fever was present among 34.7% of the patients, and Anorexia in 29.2% of the cases. In the current investigation, guarding was observed in 93.1% of instances, rebound tenderness was present in 86.1% of cases, the Rovsing test was positive in 83.3% of cases, the Psoas test was positive in 84.7% of cases, and the patient had an obturator sign in 80.6% of cases WBC count was found to be abnormal among 98.6% of the xv cases,and appendicolith was present among 33.3% of the cases. Based on the operative findings complicated acute appendicitis was noted among 43.1% of the cases and uncomplicated acute appendicitis in 56.9% of the cases. Notably, Novel Preoperative Complicated Appendicitis Score was found to have better diagnostic efficacy compared to RIPASA scoring system in eloquening cases diagnosed as complicated appendicitis in patients who had undergone surgery for acute appendicitis. Conclusion: We infer that Novel Preoperative Complicated Appendicitis Score can be used in routine practice in order to identify the complicated cases of acute form of appendicitis.