THE COMPARISON OF DIAGNOSTIC VALUE OF MODIFIED ALVARADO SCORE VS RIPASA SCORE IN ACUTE APPENDICITIS AMONG YOUNG POPULATION VISITING TERTIARY CARE CENTER.

Objective: To determine the diagnostic accuracy of the RIPASA score in acute appendicitis compared to the modifiedAlvarado score, improving diagnosis and reducing negative appendectomies. Study Design: Quasi-experimental study. Place and Duration of Study: Department of Surgery, Combined Military Hospital, Bahawalpur Pakistan, from Nov 2023 toJul 2024. Methodology: A total of 110 patients were included. Young patients from 18 years to 40 years undergoing appendectomy wereincluded. A histopathology of the sample was sent. Cut-off values of scores ≥7 and ≥7.5, were set for Alvarado and RIPASAscores, respectively. Sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were calculated. Results: Patients whose Modified Alvarado score was ≥7 were 66 whereas in RIPASA score 92 patients had scores ≥7.5. Asignificant association was found in both the scoring system and the histopathology findings. Sensitivity, specificity, negativepredictive, positive predictive values, and accuracies for modified Alvarado score were found to be 65.31%, 83.33%, 22.73%,96.97%, and 67.27%, while that of RIPASA was 92.86%, 91.69%, 61.11%, 98.91 %, and 92.73%, respectively. Conclusion: The sensitivity, specificity, positive predictive value, negative predictive value, accuracy, and predicting negativeappendectomy rates of the RIPASA scoring system as compared to Alvarado scoring are better when applied to the youngPakistani population.