Development of a clinical scoring system for appendicitis in children with presumed appendicitis
Pediatric Emergency Medicine Journal
;
: 54-61, 2018.
Artículo
en Inglés
| WPRIM
| ID: wpr-741807
ABSTRACT
PURPOSE:
To develop a clinical scoring system for children with presumed appendicitis who visit the emergency department.METHODS:
A registry based-retrospective study was conducted in the pediatric emergency department between September 2015 and December 2016. Patients aged 4 to 17 years who had a > 1 of 5 Likert scale for possibility of appendicitis were included. Multiple logistic regressions based on Akaike information criterion were performed using variables regarding clinical features and inflammatory markers to develop the clinical scoring system.RESULTS:
A total of 233 patients were included, and 93 (39.9%) had the final diagnosis of appendicitis. The final model with the lowest Akaike information criterion (171.7) consisted of 5 variables, including vomiting (1 point), absence of watery diarrhea (1 point), duration of symptoms ≤ 3 days (1 point), rebound tenderness (1 point), and white blood cell count > 10.0 × 109/L (2 points). If the clinical score was ≥ 4 of 6 points, the area under the receiver operating characteristic curve was 0.78 (95% confidence interval, 0.71-0.86) with a 78.9% sensitivity, 66.7% specificity, positive and negative predictive values of 70.0% and 76.2%, respectively, and positive and negative likelihood ratios of 2.4 and 0.3, respectively.CONCLUSION:
The 5-item clinical scoring system shows a fair performance for prediction of pediatric appendicitis. This simple tool could be applied to predict the pediatric appendicitis, and to avoid the use of potentially unnecessary computed tomography.
Texto completo:
Disponible
Índice:
WPRIM (Pacífico Occidental)
Asunto principal:
Pediatría
/
Apendicitis
/
Vómitos
/
Modelos Logísticos
/
Curva ROC
/
Técnicas de Apoyo para la Decisión
/
Sensibilidad y Especificidad
/
Diagnóstico
/
Diarrea
/
Servicio de Urgencia en Hospital
Tipo de estudio:
Estudio diagnóstico
/
Estudio observacional
/
Estudio pronóstico
/
Factores de riesgo
Límite:
Niño
/
Humanos
Idioma:
Inglés
Revista:
Pediatric Emergency Medicine Journal
Año:
2018
Tipo del documento:
Artículo
Similares
MEDLINE
...
LILACS
LIS