• Davut Tekyol, Rohat Ak, Nihat Müjdat Hökenek, Mazlum Kılıç, Kübra Kaytaz Tekyol, and Doğan Erdoğan.
• Haydarpaşa Numune Education and Research Hospital, Department of Emergency Medicine - Istanbul, Turkey.
• Rev Assoc Med Bras (1992). 2022 Sep 1; 68 (9): 1308-1312.

ObjectiveWhile abdominal pain is one of the most prevalent reasons for seeking medical attention, diagnosing elderly adults with acute appendicitis (AA) may be difficult. In this study, Raja Isteri Pengiran Anak Saleha Appendicitis (RIPASA) and Alvarado ratings were evaluated for diagnostic accuracy in patients who reported to the emergency department complaining of abdominal pain and received surgery for AA.MethodsThe data of patients over the age of 65 years who reported to the ER and had appendectomy after being diagnosed with AA were evaluated in this retrospective cohort study. For each patient, the diagnostic accuracy of the Alvarado and RIPASA scores was determined individually.ResultsA total of 86 patients were included in the research. The average patient was 71.2 years old, with a male preponderance of 46.5%. Alvarado's score was found to have an area under the curve (AUC) of 0.799, the Youden's index of 0.549, and a p-value of 0.001 after a receiver operating characteristic (ROC) study of the Alvarado score in identifying the diagnosis of AA. The AUC was 0.886 (95%CI 0.799-0.944), the Youden's index was 0.642, and a p-value of 0.001 was found in the ROC analysis of the RIPASA score in identifying the diagnosis of AA.ConclusionsWhen comparing the two scores used to diagnose AA, we found no statistically significant difference between the RIPASA and Alvarado scores (p=0.09), although the Youden's index for the RIPASA score was higher.

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