Introduction:

The RIPASA scale was developed for the diagnosis of acute appendicitis and has shown good sensitivity and diagnostic precision, especially in Asian populations.

Objective: To determine the utility of the RIPASA scale for the diagnosis of acute appendicitis.

Methods:

Observational, analytical and prospective study with 70 patients admitted and operated on with a presumptive diagnosis of acute appendicitis at the Hospital "General Freyre de Andrade" between September 2015 and December 2017.

Results:

91.4% of the cases presented appendicitis due to histological diagnosis. The most frequent symptom, sign and laboratory data were pain in the right iliac fossa (97.1%), positive rebound (100%), and leukocytosis (87.1%), respectively. The differences between the cases with and without appendicitis for the scale score were statistically significant. Cases with high scores predominated (62.8%). At 7.5 points the sensitivity was 94%, the specificity was 33%, the positive likelihood ratio was 1.41, the negative likelihood ratio was 0.19, and the diagnostic precision was 88.6%. The area under the Receiver Operating Characteristics curve was 0.81.

Conclusions:

The RIPASA scale had good sensitivity and a moderate negative likelihood ratio that would allow us to rule out negative cases with low scores. It also exhibited diagnostic accuracy and acceptable overall discriminatory performance. However, the poor specificity and very low positive likelihood ratio make it of little use as a single diagnostic means for acute appendicitis.

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