Comparación de la escala de alvarado modificada y la escala de ripasa a través de curvas ROC en el Hospital General Docente Riobamba, servicio de emergencia, junio 2010 – enero 2019.

Abstract

The purpose of this degree work is to identify the most robust scale between Modified Alvarado and the RIPASA scale to discriminate the need for surgery in patients diagnosed with acute appendicitis. This study is cross-sectional because the variables collected are between June 2010 and January 2019. To obtain the data matrix, information was compiled from 400 medical records of patients treated in the emergency service of the General Teaching Hospital Riobamba with said anomaly, considering 18 variables; 5 of quantitative type and 13 mutable statistics. To analyze the information, the imputation of missing data was carried out with the help of mutable and through regression for quantitative variables. Of the appendectomies made to patients, 50.8% correspond to men and 49.3% to women; it does not indicate a significant difference between both sexes. On the other hand, 50% of patients have an ageless than or equal to 24 years. The most common degree of appendicitis in the study is Grade II (Phlegmon appendicitis), among the main symptoms that help a diagnosis of appendicitis are migratory pain (71.5%) and pain in the right iliac fossa (98%). With respect to the analysis of the Modified Alvarado scale and RIPASA, it is obtained that the Alvarado scale using the ROC curve has an area (0.583), sensitivity (69.78%), specificity (82.78%), true-positive fraction (65.76%), true negative fraction (20%), unlike RIPASA with an area (0.594), sensitivity (88.4%), specificity (90.9%), true-positive fraction (68.90%), true negative fraction (25.58%). Concluding that the RIPASA scale presents greater certainty at the time of diagnosing acute appendicitis, but there is no very marked statistical difference concerning the Alvarado scale. Finally, it recommends the use of the RlPASA Scale in emergency services, as it demonstrates some statistical significance.