cliot (version 1.0.0)

ripasa_appendicitis_score: 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)

Value

A list containing:

RIPASA_Score

The calculated total score.

Appendicitis_Probability

Estimated likelihood category (Unlikely, Low, High, Definite).

Recommendation

Suggested management plan.

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).

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)