ToolsCalculators
RIPASA Score for Acute Appendicitis
Clinical probability of acute appendicitis (validated in Asian populations).
RIPASA Score for Acute Appendicitis
Sex
Age
Foreign national registration (foreign NRIC)
Right iliac fossa pain
Migration of pain to right iliac fossa
Anorexia
Nausea and vomiting
Duration of symptoms
Right iliac fossa tenderness
Guarding
Rebound tenderness
Rovsing sign
Fever (37-39 deg C)
Raised white cell count
Negative urinalysis
Result2.5 points
Appendicitis unlikely. Optimal decision threshold is 7.5.
- Diagnostic cut-off
- >= 7.5 points
When to use
- Estimating the likelihood of acute appendicitis in patients with right iliac fossa pain.
Formula
Weighted points across demographics, symptoms, signs, and investigations (guarding and Rovsing sign = 2 each; several items = 1 or 0.5). A total >=7.5 indicates high probability of appendicitis.
Pearls and pitfalls
- The 'foreign NRIC' item reflects the original Singapore cohort and can be omitted (score 0) elsewhere.
- A score >=7.5 gave high sensitivity in the derivation cohort while reducing negative appendicectomies.