Can RIPASA Scoring System Predict the Pathological Stage of Acute Appendicitis

Introduction. Being one of the scoring systems used in the diagnosis of acute appendicitis, the RIPASA score can be used easily with a high diagnostic accuracy. Objective. To evaluate the possible relationship between RIPASA scores and the histopathological examination results of appendectomy materials. Materials and Methods. This study retrospectively reviews 242 patients who were operated in our clinic between January 2016 and January 2018 with a prediagnosis of acute appendicitis, and the RIPASA scores calculated in the preoperative period were compared to the histopathological examination results of the appendectomy specimens. Results. The patients consisted of 124 (51.2%) females and 118 (48.8%) males. The ages of the patients ranged from 15 to 81 years. The patients were divided into 3 groups based on their RIPASA scores as low-score (4-7), intermediate-score (7.5-11.5), and high-score (12 and over) groups. There were 20 (52.6%) catarrhal-stage appendicitis cases and 17 (44.7%) normal appendixes in the low-score group; there were 70 (83.3%) catarrhal-stage appendicitis cases, 9 (10.7%) suppurative-stage appendicitis cases, 4 (4.8%) gangrenous-stage appendicitis cases, and 1 (1.2%) perforated appendicitis case in the intermediate-score group. In the high-score group, there were 53 (44.2%) suppurative-stage appendicitis cases, 51 (42.5%) gangrenous-stage appendicitis cases, 11 (9.2%) perforated appendicitis cases, and 5 (4.2%) catarrhal-stage appendicitis cases. A strong positive correlation was found between the RIPASA scores of the patients and the pathological stage of appendicitis (r=0.889; p<0.001). Conclusion. The RIPASA scoring system can make a correct and prompt diagnosis of acute appendicitis including its possible pathological stage without any need for a computed tomography.