Awareness and Utilization of the RIPASA Score for Acute Appendicitis Among Emergency and Surgical Physicians: A Cross-Sectional Study

Background: Accurate diagnosis of acute appendicitis remains challenging, and several clinical scoring systems have been developed to support decision-making. The RIPASA score has demonstrated good diagnostic performance, particularly in Asian and Middle Eastern populations; however, data on clinicians’ awareness and real-world utilization are limited. Objective: To assess awareness, utilization, and perceived barriers to the use of the RIPASA score among emergency and surgical physicians. Methods: A single-center cross-sectional survey was conducted at a tertiary care hospital in Saudi Arabia. Physicians involved in the assessment or management of suspected acute appendicitis were invited to complete an anonymous electronic questionnaire. Duplicate and incomplete responses were excluded. Descriptive statistics were used to summarize responses, and comparisons between specialties were performed using the Chi-square test. Results: Of 124 responses received, 104 were included in the final analysis after exclusion of incomplete or irrelevant questionnaires. Overall, 85.6% of participants were aware of the RIPASA score, while 52.9% reported using it in clinical practice. Surgeons reported significantly higher utilization of the RIPASA score compared with emergency medicine physicians (χ² = 6.58, p = 0.038). The most commonly reported barriers were unfamiliarity with the score (49.0%), lack of training (35.6%), and perceived time constraints (19.2%). Conclusion: Despite high awareness, utilization of the RIPASA score remains moderate, with significant variation between emergency and surgical physicians. Targeted training and integration of RIPASA into clinical workflows may improve its adoption and support more standardized diagnosis of acute appendicitis.