Validez de las escalas Ripasa y Alvarado para el diagnóstico de apendicitis aguda en el servicio de emergencia del Hospital Vicente Corral Moscoso. 2014.

Abstract

Introduction: Appendectomy is the most common emergency operation in surgical services, and can reach up to 48.7% of total emergency surgeries. Objetive: Validate Alvarado and RIPASA scales compared with histopathology for the diagnosis of acute appendicitis in the emergency service of the "Vicente Corral Moscoso" Hospital during the period January to December 2014. Material and Methods: It has been made a validation study of diagnostic tests performed in a 365 patients diagnosed with acute appendicitis; the study group consisted of patients whose ages were between 18 and 65 years. The data were collected by the author in a structured form specifically for this purpose in which consisted the two diagnostic scales and analyzed with SPSS 22.0 software. Results: The prevalence of acute appendicitis was 26,64% (95% CI 25,15% to 28,18%), being the most affected age group under 40 years (84,38%), and the average age of 32,02 + / - 10,1. The male was the most afflicted with 54,79% of cases. Of the 365 cases, Alvarado tested positive in 64,38% and RIPASA in 95,34%. Sensitivity for Alvarado score was 65%, specificity 40%, PPV 95%, NPV 6%, the likelihood ratio for a positive test (LR +) 1,08 and the likelihood ratio for a negative test ( LR-) 0,88 with p = 0,674. In the respect to RIPASA, sensitivity was 96%, specificity 20%, PPV 95%, NVP 25%, the LR + 1,2 and 0,19 LR- with a p = 0,001. Conclusions: The prevalence of appendicitis was 26,64%; with higher incidence in males and at the beginning of the third decade of life, the scale RIPASA had greater validity than Alvarado with a sensitivity of 96% and a specificity of 20%, with a value of p = 0,001