THE UTILIZATION OF ALVARADO, AIR AND RIPASA SCORING SYSTEMS IN ADULTS WITH ACUTE APPENDICITIS TREATED WITH LAPAROSCOPIC APPENDECTOMY

  • Ilija Milev Department of Surgery, Clinical Hospital-Shtip, Faculty of Medical Sciences, Goce Delchev University, Shtip, North Macedonia
  • Vesna Velikj Stefanovska Department of Epidemiology and Biostatistics, Faculty of Medicine, Ss.Cyril and Methodius University, Skopje, North Macedonia
  • Ognen Kostovski Clinic for Digestive Surgery, Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, North Macedonia
  • Aleksandar Mitevski Department of Surgery, Re-Medica General Hospital, Faculty of Medical Sciences, Goce Delcev University, Stip, North Macedonia
  • Panche Karagjozov Clinic for Digestive Surgery, Faculty of Medicine, Ss. Cyril and Methodius University in Skopje, North Macedonia
  • Stefan Petrovski Department of Surgery, Clinical Hospital-Stip, Faculty of Medical Sciences, Goce Delcev University, Stip, St. Krste Misirkov, Republic of North Macedonia

Abstract

The purpose of this study is to evaluate the applicability of Alvarado, Appendicitis Inflammatory Response (AIR) and „Raja Isteri Pengiran Anak Saleha Appendicitis “(RIPASA) score in diagnosing acute appendicitis (AA) in our population, as well as the possibility for connection between certain values and the emergence of “adverse events†in relation to laparoscopic appendectomy (LA). We conducted a multicentric, prospective, cohort, clinical study on 75 patients with AA treated with LA. For all the patients, the values and corresponding group of the three scoring systems (Alvarado, AIR and RIPASA) were determined preoperatively. We registered the emergence of intraoperative complications and difficulties, reason for conversion and the presence of complications postoperatively. All the patients with some form of intraoperative complication or difficulties, patients on whom conversion to open approach was performed or patients with any kind of postoperative complication were placed in the group “with adverse events†and the rest in the group “without adverse eventsâ€. The RIPASA score had an insignificantly higher sensitivity (sens.=96% at a cut-off ˃7 and  sens.=68% at a cut-off ˃12) than Alvarado score (sens.=90.7% at a cut-off ≥7 and sens.=62.7% at a cut-off ≥9) and both had significantly higher sensitivity than AIR score (sens.=40% at a cut-off ≥9). Further analysis showed that there was no association between the emergence of adverse events and the corresponding group of the scoring system. The RIPASA scoring system had the highest sensitivity in our population, The investigated scoring systems Alvarado, AIR and RIPASA could not be used for predicting possible unwanted course in patients with AA treated with LA.


Keywords: scoring systems, sensitivity, laparoscopic appendectomy, adverse events.

References

1. Alvarado A. A practical score for the early diagnosis of acute appendicitis. Ann Emerg Med. 1986 May;15(5):557-64.
2. Kalan M, Talbot D, Cunliffe WJ, Rich AJ. Evaluation of the modified Alvarado score in the diagnosis of acute appendicitis: a prospective study. Ann R Coll Surg Engl. 1994 Nov; 76(6): 418–9.
3. Andersson M, Andersson RE. The appendicitis inflammatory response score: a tool for the diagnosis of acute appendicitis that outperforms the Alvarado score. World J Surg. 2008 Aug;32(8):1843-9.
4. Chong CF, Adi MI, Thien A, Suyoi A, Mackie AJ, Tin AS, Tripathi S, Jaman NH, Tan KK, Kok KY, Mathew VV, Paw O, Chua HB, Yapp SK. Development of the RIPASA score: a new appendicitis scoring system for the diagnosis of acute appendicitis. Singapore Med J. 2010 Mar;51(3):220-5.
5. Chong CF, Thien A, Mackie AJ, Tin AS, Tripathi S, Ahmad MA, Tan LT, Ang SH, Telisinghe PU. Comparison of RIPASA and Alvarado scores for the diagnosis of acute appendicitis. Singapore Med J. 2011 May;52(5):340-5.
6. Ohle R, O'Reilly F, O'Brien KK, Fahey T, Dimitrov BD. The Alvarado score for predicting acute appendicitis: a systematic review. BMC Med. 2011 Dec 28;9:139.
7. Frountzas M, Stergios K, Kopsini D, Schizas D, Kontzoglou K, Toutouzas K. Alvarado or RIPASA score for diagnosis of acute appendicitis? A meta-analysis of randomized trials. Int J Surg. 2018 Aug;56:307-14.
8. Favara G, Maugeri A, Barchitta M, Ventura A, Basile G, Agodi A. Comparison of RIPASA and ALVARADO scores for risk assessment of acute appendicitis: A systematic review and meta-analysis. PLoS One. 2022 Sep 30;17(9):e0275427.
9. de Castro SM, Unlu C, Steller EP, van Wagensveld BA, Vrouenraets BC. Evaluationofthe appendicitis inflammatory response score for patients with acute appendicitis. World J Surg. 2012 Jul;36(7):1540-5.
10. Kularatna M, Lauti M, Haran C, MacFater W, Sheikh L, Huang Y, McCall J, MacCormick AD. Clinical Prediction Rules for Appendicitis in Adults: Which Is Best? World J Surg. 2017 Jul;41(7):1769-1781.
11. Malik MU, Connelly TM, Awan F, Pretorius F, Fiuza-Castineira C, El Faedy O, Balfe P. The RIPASA score is sensitive and specific for the diagnosis of acute appendicitis in a western population. Int J Colorectal Dis. 2017 Apr;32(4):491-7.
12. Madasi V. Comparison of predictive validity of Alvarado score and Appendicitis Inflammatory Response (AIR) Score, a hospital based observational study. Int J surg Orthopedics 2016;2(3):29-34.
13. Kollar D, McCartan DP, Bourke M, Cross KS, Dowdall J. Predicting acute appendicitis? A comparison of the Alvarado score, the Appendicitis Inflammatory Response Score and clinical assessment. World J Surg. 2015 Jan;39(1):104-9.
14. Karami MY, Niakan H, Zadebagheri N, Mardani P, Shayan Z, Deilami I. Which one is better? Comparison of the Acute Inflammatory Response, Raja Isteri Pengiran Anak Saleha Appendicitis and Alvarado scoring systems. Ann Coloproctol. 2017 Dec;33(6):227-31.
15. Nanjundaiah N, Mohammed A, Shanbhag V, Ashfaque K, Priya SA. A comparative study of RIPASA score and Alvarado score in the diagnosis of acute appendicitis. J Clin Diagn Res. 2014 Nov;8(11):NC03-5.
16. Gorter RR, Eker HH, Gorter-Stam MA, Abis GS, Acharya A, Ankersmit M at al. Diagnosis and management of acute appendicitis. EAES consensus development conference 2015. Surg Endosc. 2016 Nov;30(11):4668-4690.
17. Di Saverio S, Podda M, De Simone B, Ceresoli M, Augustin G, Gori A at al. Diagnosis and treatment of acute appendicitis: 2020 update of the WSES Jerusalem guidelines. World J Emerg Surg. 2020 Apr 15;15(1):27
18. Candranata DPE, Christian NWS, Wiargitha K, Suwedagatha G, Adiputra PAT, Sueta MAD. Relationship between high Alvarado scores and complicate acute appendicitis in acute appendicitis patients that undergo appendicectomy surgery. International Journal of Research and Review. 2022; 9(6): 150-156.
19. Sousa-Rodrigues CF, Rocha AC, Rodrigues AK, Barbosa FT, Ramos FW, Valoes SH. Correlation between the Alvarado scale and the macroscopic aspect of the appendix in patients with appendicitis. Rev Col Bras Cir. 2014 Sep-Oct;41(5):336-9.
20. Antonacci N, Ricci C, Taffurelli G, Monari F, Del Governatore M, Caira A, Leone A, Cervellera M, Minni F, Cola B. Laparoscopic appendectomy: Which factors are predictors of conversion? A high-volume prospective cohort study. Int J Surg. 2015 Sep;21:103-7.
Published
2023-11-04
How to Cite
MILEV, Ilija et al. THE UTILIZATION OF ALVARADO, AIR AND RIPASA SCORING SYSTEMS IN ADULTS WITH ACUTE APPENDICITIS TREATED WITH LAPAROSCOPIC APPENDECTOMY. Journal of Morphological Sciences, [S.l.], v. 6, n. 2, p. 120-132, nov. 2023. ISSN 2545-4706. Available at: <https://jms.mk/jms/article/view/vol6no2-17>. Date accessed: 27 july 2024.
Section
Articles