ripasa_appendicitis_score: RIPASA Score for Acute Appendicitis

In cliot: Clinical Indices and Outcomes Tools

RIPASA Score for Acute Appendicitis

Description

Calculates the RIPASA score, a diagnostic scoring system developed to improve the sensitivity and specificity of diagnosing acute appendicitis, particularly in Asian and Middle Eastern populations compared to the Alvarado score. It utilizes 15 clinical and demographic parameters.

Usage

ripasa_appendicitis_score(sex, age, rif_pain, pain_migration, anorexia,
                          nausea_vomiting, symptom_duration_lt_48h, rif_tenderness,
                          guarding, rebound_tenderness, rovsing_sign, fever,
                          elevated_wbc, negative_urinalysis, foreign_national)

Arguments

sex	String. Patient sex ("Male" or "Female"). (Male +1, Female +0.5).
age	Numeric. Patient age in years. (<40y +1, >=40y +0.5).
rif_pain	Numeric (0 or 1). Pain in the Right Iliac Fossa. (1 = Yes, +0.5).
pain_migration	Numeric (0 or 1). Migration of pain to the RIF. (1 = Yes, +0.5).
anorexia	Numeric (0 or 1). Anorexia. (1 = Yes, +1).
nausea_vomiting	Numeric (0 or 1). Nausea and/or vomiting. (1 = Yes, +1).
symptom_duration_lt_48h	Numeric (0 or 1). Duration of symptoms less than 48 hours. (1 = Yes, +1; 0 (>48h) = +0.5).
rif_tenderness	Numeric (0 or 1). Tenderness in the RIF. (1 = Yes, +1).
guarding	Numeric (0 or 1). Guarding in the RIF. (1 = Yes, +2).
rebound_tenderness	Numeric (0 or 1). Rebound tenderness. (1 = Yes, +1).
rovsing_sign	Numeric (0 or 1). Positive Rovsing's sign. (1 = Yes, +2).
fever	Numeric (0 or 1). Fever (typically > 37.5C or 99.5F). (1 = Yes, +1).
elevated_wbc	Numeric (0 or 1). Elevated White Blood Cell count. (1 = Yes, +1).
negative_urinalysis	Numeric (0 or 1). Negative urinalysis (absence of blood/nitrites/leukocytes). (1 = Yes, +1).
foreign_national	Numeric (0 or 1). Is the patient a foreign national (relative to the derivation setting, e.g., foreign NRIC)? (1 = Yes, +1).

Value

A list containing:

RIPASA_Score	The calculated total score.
Appendicitis_Probability	Estimated likelihood category (Unlikely, Low, High, Definite).
Recommendation	Suggested management plan.

References

Chong CF, Adi MI, Thien A, et al. Development of the RIPASA score: a new appendicitis scoring system for the diagnosis of acute appendicitis. Singapore Med J. 2010;51(3):220-225.

Examples

# Example 1: High Probability
# Male (+1), 30y (+1), RIF Pain (+0.5), Migration (+0.5), Guarding (+2), Rebound (+1), High WBC (+1)
# Score = 7.0
ripasa_appendicitis_score("male", 30, 1, 1, 0, 0, 1, 1, 1, 1, 0, 0, 1, 0, 0)

# Example 2: Definite Appendicitis
# Male, 25y, All signs positive except foreign national
# Score > 12
ripasa_appendicitis_score("male", 25, 1, 1, 1, 1, 1, 1, 1, 1, 1, 1, 1, 1, 0)

cliot documentation built on Dec. 1, 2025, 1:06 a.m.