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Abstract：
BACKGROUND: Acute appendicitis is the most common surgical emergency in Ethiopian clinical practice. Although a multitude of scoring systems have been used in clinical practice, none have been universally validated. The purpose of this study was to validate the Raja Isteri Pengiran Anak Saleha Appendicitis (RIPASA) scoring system in the Ethiopian context.
METHODS: A total of 315 consecutive patients who presented with a presumptive diagnosis of acute appendicitis and were planned to undergo appendectomy were studied. All the studied patients had diagnostic sonography and underwent the RIPASA scoring system. The sensitivity, specificity, positive predictive value, and negative predictive value of RIPASA and ultrasound results with intraoperative gross examinations.
RESULTS: The mean age of the participants was 27.4 ± 11.5 years, with a male-to-female ratio of 1.6:1. The concordance between ultrasound and RIPASA for the diagnosis of acute appendicitis was 93.6%. The sensitivity, specificity, positive predictive value, and negative predictive value of RIPASA were 96.2%, 30.8%, 93.9%, and 42.1%, respectively. Similarly, the sensitivity, specificity, positive predictive value, and negative predictive value of ultrasound were 95.3%, 27.8%, 95.6%, and 26.3%, respectively. White cell count and RIPASA scores were weakly correlated with intraoperative stages of acute appendicitis, r(313) = 0.18, p = 0.001, and r(313) = 0.129, p = 0.022, respectively. The rate of a negative appendectomy was 6%.
CONCLUSIONS: RIPASA and ultrasound had equivalent performance in the diagnosis of acute appendicitis. In both cases, the rate of negative appendectomy was low enough to validate RIPASA for clinical practice in low-income institutions where sonographic diagnosis by a conventionally trained radiologist is not available.
METHODS: A total of 315 consecutive patients who presented with a presumptive diagnosis of acute appendicitis and were planned to undergo appendectomy were studied. All the studied patients had diagnostic sonography and underwent the RIPASA scoring system. The sensitivity, specificity, positive predictive value, and negative predictive value of RIPASA and ultrasound results with intraoperative gross examinations.
RESULTS: The mean age of the participants was 27.4 ± 11.5 years, with a male-to-female ratio of 1.6:1. The concordance between ultrasound and RIPASA for the diagnosis of acute appendicitis was 93.6%. The sensitivity, specificity, positive predictive value, and negative predictive value of RIPASA were 96.2%, 30.8%, 93.9%, and 42.1%, respectively. Similarly, the sensitivity, specificity, positive predictive value, and negative predictive value of ultrasound were 95.3%, 27.8%, 95.6%, and 26.3%, respectively. White cell count and RIPASA scores were weakly correlated with intraoperative stages of acute appendicitis, r(313) = 0.18, p = 0.001, and r(313) = 0.129, p = 0.022, respectively. The rate of a negative appendectomy was 6%.
CONCLUSIONS: RIPASA and ultrasound had equivalent performance in the diagnosis of acute appendicitis. In both cases, the rate of negative appendectomy was low enough to validate RIPASA for clinical practice in low-income institutions where sonographic diagnosis by a conventionally trained radiologist is not available.
摘要：
背景：急性阑尾炎是埃塞俄比亚临床实践中最常见的外科急症。尽管许多评分系统已经在临床实践中使用，没有一个得到普遍验证。这项研究的目的是在埃塞俄比亚背景下验证RajaIsteriPengiranAnakSaleha阑尾炎（RIPASA）评分系统。
方法：共研究了315例连续的患者，这些患者被诊断为急性阑尾炎并计划接受阑尾切除术。所有研究的患者均进行了诊断性超声检查，并接受了RIPASA评分系统。敏感性,特异性，正预测值，术中大体检查的RIPASA和超声结果的阴性预测值。
结果：参与者的平均年龄为27.4±11.5岁，男女比例为1.6:1。超声与RIPASA诊断急性阑尾炎的符合率为93.6%。敏感性,特异性，正预测值，RIPASA的阴性预测值为96.2%，30.8%,93.9%,和42.1%，分别。同样，灵敏度,特异性，正预测值，超声阴性预测值为95.3%,27.8%,95.6%,和26.3%，分别。白细胞计数和RIPASA评分与急性阑尾炎的术中分期弱相关,r(313)=0.18,p=0.001,r(313)=0.129,p=0.022。阑尾切除术的阴性率为6％。
结论：RIPASA和超声在诊断急性阑尾炎方面具有同等的表现。在这两种情况下，阑尾切除术的阴性率很低,足以验证RIPASA在低收入机构的临床实践中的有效性,在这些机构中,常规放射科医师无法进行超声诊断.
方法：共研究了315例连续的患者，这些患者被诊断为急性阑尾炎并计划接受阑尾切除术。所有研究的患者均进行了诊断性超声检查，并接受了RIPASA评分系统。敏感性,特异性，正预测值，术中大体检查的RIPASA和超声结果的阴性预测值。
结果：参与者的平均年龄为27.4±11.5岁，男女比例为1.6:1。超声与RIPASA诊断急性阑尾炎的符合率为93.6%。敏感性,特异性，正预测值，RIPASA的阴性预测值为96.2%，30.8%,93.9%,和42.1%，分别。同样，灵敏度,特异性，正预测值，超声阴性预测值为95.3%,27.8%,95.6%,和26.3%，分别。白细胞计数和RIPASA评分与急性阑尾炎的术中分期弱相关,r(313)=0.18,p=0.001,r(313)=0.129,p=0.022。阑尾切除术的阴性率为6％。
结论：RIPASA和超声在诊断急性阑尾炎方面具有同等的表现。在这两种情况下，阑尾切除术的阴性率很低,足以验证RIPASA在低收入机构的临床实践中的有效性,在这些机构中,常规放射科医师无法进行超声诊断.
