Artículo
Diagnostic Value of Clinical Prediction Scores for Acute Appendicitis in Children Younger than 4 Years
Fecha de publicación:
04/2022
Editorial:
Georg Thieme Verlag Kg
Revista:
European Journal Of Pediatric Surgery
ISSN:
0939-7248
e-ISSN:
1439-359X
Idioma:
Inglés
Tipo de recurso:
Artículo publicado
Clasificación temática:
Resumen
Introduction: Acute appendicitis can be difficult to diagnose, especially in children < 4 years old. The aim of the present study was to assess the diagnostic value of Alvarado score (AS), appendicitis inflammatory response (AIR) score, and pediatric appendicitis score (PAS) in children younger than 4 years. Materials and Methods: All children younger than 4 years who underwent appendicectomy between 2005 and 2019 were included retrospectively. The diagnostic performance of the scores was analyzed using the area under the receiver-operating characteristic (ROC) curve and by calculating the diagnostic performances at optimal criterion value cutoff points. Results: In this study, 100 children were included (58 boys and 42 girls) with a median age of 39.5 (12-47) months. Ninety children were diagnosed with pathologically proven acute appendicitis. The area under ROC curve of AS was 0.73, AIR score was 0.79, and PAS was 0.69 (p > 0.05, respectively). In children with low risk of acute appendicitis, negative predictive values were 75.0% for AS, 50.0% for AIR score, and 66.7% for PAS (p < 0.05, respectively). The positive predictive values in children with high risk of acute appendicitis were of 92.7% for AS, 92.6% for AIR score, and 93.6% for PAS (p > 0.05, respectively). AS, AIR score, and PAS plus positive ultrasonography have 0.58, 0.49, and 0.88 area under ROC curve. Conclusion: The three scores can be of assistance in the suspicion of acute appendicitis. PAS markedly improved combined with positive ultrasonography, but none can be used in setting the diagnosis of acute appendicitis in young children.
Palabras clave:
APPENDICITIS
,
CLINICAL PREDICTION SCORES
,
DIAGNOSIS
,
PRESCHOOL CHILDREN
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Licencia
Identificadores
Colecciones
Articulos(INICSA)
Articulos de INSTITUTO DE INVESTIGACIONES EN CIENCIAS DE LA SALUD
Articulos de INSTITUTO DE INVESTIGACIONES EN CIENCIAS DE LA SALUD
Citación
Rassi, Ricardo; Muse, Florencia; Sánchez, José; Cuestas, Eduardo; Diagnostic Value of Clinical Prediction Scores for Acute Appendicitis in Children Younger than 4 Years; Georg Thieme Verlag Kg; European Journal Of Pediatric Surgery; 32; 2; 4-2022; 198-205
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