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. 2022 Jan;64(1):e14918.
doi: 10.1111/ped.14918.

Applying the Pediatric Appendicitis Score to predict complicated appendicitis in children

Takayuki Fujii  1 , Aya Tanaka  1 , Hiroto Katami  1 , Ryuichi Shimono  1
Affiliations

Applying the Pediatric Appendicitis Score to predict complicated appendicitis in children

Takayuki Fujii et al. Pediatr Int. 2022 Jan.

Abstract

Background: This study aimed to investigate the efficacy of the Pediatric Appendicitis Score (PAS) and other indicators to enable the prediction of complicated appendicitis (CA) in children.

Methods: This retrospective cohort study evaluated children (n = 161) aged ≤16 years with acute appendicitis between 2008 and 2020. Demographic data, symptoms, physical findings, laboratory data, and PASs were collected. Multivariate analysis was performed to identify predictors for CA. Receiver operating characteristic (ROC) curves were constructed. The diagnostic performance of each predictor was evaluated.

Results: Multivariate analysis identified three predictors for CA: duration of symptoms >1 day, C-reactive protein (CRP) level > 4 mg/dL, and PAS ≥ 8. The ROC curve of the combined three predictors showed an area under the curve of 0.91. The multivariate ROC curve revealed that the presence of a PAS contributed to a significant improvement in the diagnosis of CA compared to the absence of PAS. When combined, the three predictors had a high specificity of 99% and positive predictive value of 98%.

Conclusions: A symptom duration >1 day, CRP > 4 mg/dL, and PAS ≥ 8 were predictors for CA. The PAS can be useful for prediction of CA when combined with the duration of symptoms, CRP, or both.

Keywords: appendectomy; complex appendicitis; diagnosis; pediatric surgery; perforated appendicitis.

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References

    1. Di Saverio S, Podda M, De Simone B et al. Diagnosis and treatment of acute appendicitis: 2020 update of the WSES Jerusalem guidelines. World J. Emerg. Surg. 2020; 15: 27.
    1. Yu YR, Rosenfeld EH, Dadjoo S et al. Accuracy of surgeon prediction of appendicitis severity in pediatric patients. J. Pediatr. Surg. 2019; 54: 2274-8.
    1. Abo A, Shannon M, Taylor G, Bachur R. The influence of body mass index on the accuracy of ultrasound and computed tomography in diagnosing appendicitis in children. Pediatr. Emerg. Care. 2011; 27: 731-6.
    1. Kim HY, Park JH, Lee YJ, Lee SS, Jeon JJ, Lee KH. Systematic review and meta-analysis of CT features for differentiating complicated and uncomplicated appendicitis. Radiology 2018; 287(1): 104-15.
    1. Brenner D, Elliston C, Hall E, Berdon W. Estimated risks of radiation-induced fatal cancer from pediatric CT. Am. J. Roentgenol. 2001; 176: 289-96.

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