背景和目的阑尾炎是腹痛的常见原因。由于许多医疗中心的成像服务有限,并且迫切需要减少大量不必要的阑尾切除术,已经构建了几种临床诊断工具。一种新颖的诊断工具,称为RajaIsteriPengiranAnakSaleha阑尾炎(RIPASA)评分,已创建以协助识别亚洲国家的急性阑尾炎(AA)。该研究旨在评估RIPASA评分与病理检查确定的阑尾炎严重程度之间的相关性。材料和方法该研究是在穆斯林教育协会(MES)医学院Perinthalmanna的普通外科进行的为期12个月的前瞻性观察性调查。该研究包括所有被诊断为AA并接受阑尾切除术的患者,只要他们满足纳入和排除标准。使用预先构造的形式对225名个体的便利样本进行了分析。RIPASA评分是在手术前估计的,考虑到他们的年龄,性别,症状,体检结果,和实验室发现。随后将这些评分与阑尾切除术后获得的组织病理学结果进行对比。根据他们的RIPASA评分将个体分为三组。得分较低的类别,分数在4到7之间。中间分数类别由7.5到11.5的分数组成,而较高分数类别包括12及以上的分数。这些评分与组织病理学报告(HPR)相关,以确定是否存在阑尾炎,穿孔阑尾,阑尾脓肿,或没有观察到的病理学。结果研究人群中男性137人(60.9%),女性88人(39.1%)。其中,177人(78.7%)年龄小于40岁,而48例(21.3%)年龄在40岁以上。在225个案例中,146例AA(64.9%),27例(12%)阑尾脓肿,阑尾穿孔41例(18.2%)。在低分数组的225例中,有11例出现了正常的阑尾。发现组织病理学报告与RIPASA评分之间的关联具有统计学高度显著性(p=0.000)。在低分组中,阑尾炎14例(53.8%),1例阑尾脓肿(3.8%),共有11例未观察到病理(42.3%),无阑尾穿孔报告。在中级分数类别中,阑尾炎121例(89.6%),阑尾脓肿12例(8.9%),阑尾穿孔2例(1.5%),并且没有报告非病理类别的病例。在高分类别中,阑尾炎11例(17.2%),阑尾脓肿14例(21.9%),阑尾穿孔39例(60.9%),无阴性阑尾切除术报告。结论研究表明,RIPASA评分系统对AA具有较高的诊断效能。这个评分系统是一个有效的,可靠,成本效益高,非侵入性,可重复,和安全的诊断技术,不需要额外的费用或关注。
Background and objectives Appendicitis is a frequent cause of abdominal pain. Because of the limited availability of imaging services in many medical centers and an urge to reduce the substantial number of unnecessary appendectomies, several clinical diagnostic tools have been constructed. A novel diagnostic tool, referred to as the Raja Isteri Pengiran Anak Saleha Appendicitis (RIPASA) score, has been created to assist in identifying acute appendicitis (AA) in Asian nations. The study aimed to assess the correlation between RIPASA scores and the severity of appendicitis as determined by pathological examination. Materials and methods The study was a prospective observational investigation undertaken in the Department of General Surgery at Muslim education society (MES) Medical College Perinthalmanna over 12 months. The study included all patients who had been diagnosed with AA and underwent appendectomy, provided they satisfied both the inclusion and exclusion criteria. An analysis was conducted on a convenience sample of 225 individuals using a prestructured proforma. The RIPASA scores were estimated before their surgery, taking into account their age, gender, symptoms, physical examination findings, and laboratory findings. These scores were subsequently contrasted with the histopathological results obtained after the appendectomy. The individuals were categorized into three groups according to their RIPASA scores. The lower-score category, scores between 4 and 7. The intermediate-score category consists of scores ranging from 7.5 to 11.5, while the higher-score category includes scores of 12 and above. These scores are correlated with the histopathology report (HPR) to determine the presence of appendicitis, perforated appendix, appendicular abscess, or the absence of pathology observed. Results The study population comprised of 137 (60.9%) males and 88 (39.1%) females. Among these, 177 individuals (78.7%) were younger than 40 years, while 48 individuals (21.3%) were older than 40 years. Out of 225 cases, 146 cases were AA (64.9%), 27 (12%) appendicular abscess cases, and 41 (18.2%) appendicular perforation cases. The normal appendix was noted in 11 out of 225 cases in the low-score group. The association between the histopathological report and RIPASA score was found to be statistically highly significant (p=0.000). In the low-score group, there were 14 cases of appendicitis (53.8%), one case of appendicular abscess (3.8%), a total of 11 cases without pathology observed (42.3%), and no reported instances of appendicular perforation. In the intermediate-score category, there were 121 cases of appendicitis (89.6%), 12 cases of appendicular abscess (8.9%), 2 cases of appendicular perforation (1.5%), and no reported cases in the non-pathology category. Among the high-score category, there were 11 cases of appendicitis (17.2%), 14 cases of appendicular abscess (21.9%), 39 cases of appendicular perforation (60.9%), and no reported instances of negative appendectomy. Conclusion The study has shown that the RIPASA scoring system had a high diagnostic efficacy in identifying AA. This scoring system is an effective, dependable, cost-effective, noninvasive, reproducible, and safe diagnostic technique that does not require additional expenses or concerns.