The diagnostic accuracy of Lintula, RIPASA and Alvarado scoring systems for diagnosis of acute appendicitis


  • Suchana lamjitsopa Emergency department, Ban Bueng Hospital
  • Vicha Tunsiri Emergency department, Chonburi Hospital
  • Tharathorn Durongbhandhu Emergency department, Chonburi Hospital


Acute appendicitis, Lintula, RIPASA, Alvarado score


Introduction : The acute appendicitis is a common surgical condition that was found in the emergency department. The rapid and accurate diagnosis will reduce complications and costs. Therefore, the scoring systems were developed to determine the diagnostic aids. Firstly, Lintula score is based on patients' past medical history and physical examination. Secondly, RIPASA score which is well-designed for the diagnosis among the Asian patients. While, Alvarado score was evaluated and validated in numerous studies; however, it lacks creditability among the Asian patients

Objectives : To study the diagnostic accuracy of Lintula, RIPASA and Alvarado scoring systems in the diagnosis of acute appendicitis

Method : The Prospective Cohort Study. We analyzed the data by STATA version 15.0 from 66 adult patients who visited the Emergency department at Chonburi hospital having right lower quadrant abdominal pain between 30th July - 31st December 2020. Lintula (z21), RIPASA (z7.5) and Alvarado scores (27) were compared. Then we calculated the sensitivity, specificity, PPV, NPV and AUROC curves.

Results : The sensitivity, specificity, PPV and NPV of Lintula score (221) were respectively 45.7%, 75%, 80.8% and 37.5%. However, Lintula score (z17) were 80.4%, 55%, 80.4% and 55%. RIPASA score (=7.5) were 84.8%, 45%, 78% and 56.2%. Alvarado score (z7) were 71.7%, 50%, 76.7% and 43.5%. AUROC of RIPASA, Lintula and Alvarado scores were 0.685, 0.678 and 0.656

Conclusion : Lintula, RIPASA and ALVARADO score provide similar results for diagnosis acute appendicitis. Followed by Lintula and Alvarado score. Lintula score (217) sensitivity becomes higher than Lintula score (221).


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How to Cite

lamjitsopa S, Tunsiri V, Durongbhandhu T. The diagnostic accuracy of Lintula, RIPASA and Alvarado scoring systems for diagnosis of acute appendicitis. TJEM [Internet]. 2021 Jul. 1 [cited 2024 Jun. 24];2(2):37-50. Available from: