Development of a clinical scoring system for appendicitis in children with presumed appendicitis
Pediatric Emergency Medicine Journal
;
: 54-61, 2018.
Artigo
em Inglês
| 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:
DisponíveL
Índice:
WPRIM (Pacífico Ocidental)
Assunto principal:
Pediatria
/
Apendicite
/
Vômito
/
Modelos Logísticos
/
Curva ROC
/
Técnicas de Apoio para a Decisão
/
Sensibilidade e Especificidade
/
Diagnóstico
/
Diarreia
/
Serviço Hospitalar de Emergência
Tipo de estudo:
Estudo diagnóstico
/
Estudo observacional
/
Estudo prognóstico
/
Fatores de risco
Limite:
Criança
/
Humanos
Idioma:
Inglês
Revista:
Pediatric Emergency Medicine Journal
Ano de publicação:
2018
Tipo de documento:
Artigo
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