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All Journal Zona Kedokteran: Program Studi Pendidikan Dokter Universitas Batam Jurnal Sains dan Kesehatan Journal of International Surgery and Clinical Medicine
Muhammad Azmi Fanany
Universitas Batam
Dentistry Health Professions Medicine & Pharmacology Nursing Public Health Veterinary

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Diagnostic Accuracy of the RIPASA and Alvarado Scores in Screening for Acute Appendicitis: A Histopathology-Based Retrospective Validation Study Muhammad Azmi Fanany; Elvita Nora Susana; Malahayati Rusli Bintang
Jurnal Sains dan Kesehatan Vol. 10 No. 1 (2026): Juni : Jurnal Sains dan Kesehatan (JUSIKA)
Publisher : Universitas Muhamadiyah Manado

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.57214/jusika.v10i1.1219

Abstract

Background: Acute appendicitis is the most common abdominal surgical emergency, yet its diagnosis remains a clinical dilemma owing to frequently atypical presentations. Clinical scoring systems were developed to expedite and improve diagnostic accuracy. This study aimed to compare the diagnostic accuracy of the RIPASA and Alvarado scores against histopathology as the gold standard. Methods: A retrospective cross-sectional analytic study of 125 patients with suspected acute appendicitis who underwent appendectomy at Hj. Bunda Halimah Hospital, Batam, between 1 January 2022 and 31 December 2024. The Alvarado (cut-off ≥7) and RIPASA (cut-off ≥7.5) scores were derived from medical records and compared with histopathology. Sensitivity, specificity, positive (PPV) and negative (NPV) predictive values, accuracy, and the area under the curve (AUC) were analysed. Results: Histopathology confirmed appendicitis in 114 of 125 patients (91.2%; negative appendectomy rate 8.8%). The Alvarado score yielded a sensitivity of 87.7%, specificity 63.6%, PPV 96.1%, NPV 33.3%, and accuracy 85.6% (AUC 0.797; 95%CI 0.715–0.863). The RIPASA score yielded a sensitivity of 91.2%, specificity 54.5%, PPV 95.4%, NPV 37.5%, and accuracy 88.0% (AUC 0.847; 95%CI 0.772–0.905). Conclusion: Both scores demonstrated good and comparable discriminative capacity; RIPASA tended to be more sensitive and marginally more accurate, whereas Alvarado was more specific. The overlapping AUC confidence intervals preclude a conclusion of statistically significant superiority of RIPASA. Both instruments are suitable screening tools in resource-limited, imaging-scarce settings.
KORELASI USIA, KADAR LEUKOSIT, DAN KADAR ALBUMIN TERHADAP LUARAN INFEKSI LUKA OPERASI PADA PASIEN PASCA AMPUTASI MAYOR Darul Ilham; Lauhil Mahfudz; Nanda Subhan; Muhammad Azmi Fanany; Khalikul Razi; Maria Meildi
Zona Kedokteran: Program Studi Pendidikan Dokter Universitas Batam Vol 16 No 3 (2026): Zona Kedokteran: Program Studi Pendidikan Dokter Universitas Batam
Publisher : Universitas Batam

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37776/zked.v16i3.2233

Abstract

Surgical site infection (SSI) following major amputation is a serious complication with a global incidence of 7-30%, particularly in patients with diabetes mellitus. Major risk factors include advanced age, hypoalbuminemia, and uncontrolled diabetes, with dominant pathogens E. coli and S. aureus. This analytical observational study aimed to describe the profile of SSI patients post-major amputation and identify risk factors at RSU dr. Zainoel Abidin Banda Aceh from October-November 2023. Secondary data from 46 medical records of patients meeting inclusion criteria (SSI post-major amputation) were excluded if incomplete, and analyzed using univariate and bivariate methods with Spearman correlation test (P<0.05). Results showed most patients aged 56-65 years (37.0%), with leukocyte levels >10.0 × 10³/mm³ in 71.7%, Escherichia coli bacterial culture (41.3%), moderate infection severity (50.0%), and low albumin levels (60.9%). Significant correlations were found between age and albumin levels with SSI occurrence (P<0.05). Conclusion: Advanced age and hypoalbuminemia correlate with SSI following major amputation. Recommendations for future research include evaluation of prophylactic antibiotics, operative duration, and prevention strategies. Keywords: Surgical site infection, albumin, leukocytosis, age, amputation, diabetes
Co-Authors Andi Ipaljri Saputra Andi Ipaljri Saputra Andreas Bellinda Paterasari Christina, Yani Dahril Darul Ilham Darul Ilham Elvita Nora Susana Fachrul Jamal Ferry Erdani Ismy, Jufriady Istiqa Syaraya Putri Jufriady Ismy Khalikul Razi Khalikul Razi Kiki Zulfikri Lauhil Mahfudz Malahayati Rusli Bintang Maria Meildi Merysia Karmila Muhammad Puteh Mauny Muhammad Ridha MUHAMMAD YUSUF Muslim Nanda Subhan Nasution, Tia Helvita Sari Nova, Aura Dewi Raju Sabran Richardo Richard Handoko RR. Ella Evrita Hestiandari Safrizal Rahman Subhan, Nanda Wifa Nur Yasmin Yasser Kuddah