RIPASA Score for Acute Appendicitis
Raja Isteri Pengiran Anak Saleha Appendicitis (RIPASA) score for acute appendicitis. Validated in Asian populations; more sensitive than Alvarado in this demographic.
Score interpretation
RIPASA below 5 — acute appendicitis unlikely.
→ Consider alternative diagnoses; discharge with safety-net advice or observe if concern persists.
RIPASA 5–7 — low probability of appendicitis.
→ Observe and re-score (Chong 2010: re-assess in 1–2 hours); imaging (ultrasound or CT) if uncertain.
RIPASA 7.5–11.5 — high probability (≥ 7.5 is the diagnostic cut-off).
→ Surgical review; imaging if available; prepare for appendicectomy.
RIPASA 12 or more — appendicitis definite in the derivation study.
→ Surgical review for appendicectomy; pre-operative antibiotics.
Interpretation bands for the RIPASA Score. Apply clinical judgement and local guidance.
References
- Chong CF 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.
Related
Curated clinical cross-links plus same-class fallbacks.
- Methoxyflurane · Inhaled Analgesic — Acute Pain
- Morphine (Orthopaedic Acute Pain) · Opioid Analgesic — Strong
- Dexketoprofen (Acute Musculoskeletal Pain) · NSAID — Non-selective COX Inhibitor (S-enantiomer of Ketoprofen)
- Labetalol (IV — Hypertensive Emergency) · Combined Alpha-1 and Beta-Adrenergic Blocker
- Glyceryl Trinitrate (Sublingual / IV) · Nitrate / Acute Angina
- Dobutamine (Acute HF / Stress Echo) · Inotrope / Acute Heart Failure
- Acute Liver Failure · EASL 2017 / BSG
- Decompensated Cirrhosis · BSG 2015 / EASL 2018
- IBD Acute Flare Assessment · ECCO / BSG 2019
- Hepatitis B Management · EASL 2017 / NICE NG33
- Dysphagia Assessment Pathway · BSG 2010 / NICE NG12
- Paracetamol overdose · TOXBASE/NPIS; MHRA DSU 2012/2024; SNAP regimen (Lancet 2014)
Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.