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Background: Acute appendicitis is the most common surgical emergency traditionally diagnosed clinically with laboratory and imaging methods with a negative appendicectomy rate of 15-20%.These facts lead to the development of multiple scoring systems of them two commonly used RIPASA and Modified Alvarado score are being compared in the present study. Methods: In a hospital based longitudinal study, clinically suspected cases of acute appendicitis that underwent appendicectomy were included as cases. Pre-operative assessment Modified Alvarado score and RIPASA score were study factors. And Histopathology of the appendix was the outcome factor. Apart from descriptive statistic, diagnostic accuracy was calculated for both scores with validation of cut off score were carried out by plotting of ROC curve. Results: Total 129 patients with a mean age of 31±9.71, male to female ratio of 1.8:1 were enrolled. Negative appendicectomy rate was 6.2% and accuracy of the RIPASA score was 80.5% and Modified Alvarado score was 50.39%. The validated cut off for both scores was >7.5. Conclusions: RIPASA scoring system has higher sensitivity and specificity compared to Modified Alvarado score. It also has higher diagnostic accuracy and a better scoring system for accurate diagnosis of acute Appendicitis in the local population.

ACUTE APPENDICITIS: A COMPARISON OF ROLE OF RIPASA AND MODIFIED ALVARADO SCORE IN ACCURATE DIAGNOSIS