From RIFT Audit to RIFT Turkey: Reappraising Appendicitis Risk Models for Global Relevance

Abstract

The Right Iliac Fossa Treatment (RIFT) Audit has made a substantial contribution to optimizing appendicitis management by systematically evaluating risk prediction models across different healthcare settings. Conducted in the UK, Italy, Portugal, Ireland, and Spain, this prospective study analysed data from 5,345 patients across 154 hospitals to assess the utility of various risk models in identifying patients at low risk for appendicitis. The audit revealed significant diagnostic challenges, especially in women, who exhibited higher rates of normal appendectomy (NAR) than men, with considerable variability between countries. Among the 15 evaluated models, the Adult Appendicitis Score (AAS) and the Appendicitis Inflammatory Response Score (AIRS) were identified as the most effective tools for men and women, respectively, underscoring the potential of risk scores to guide clinical decisions, reduce unnecessary surgeries, and reduce healthcare costs.