Development of a clinical scoring system for appendicitis in children with presumed appendicitis
Pediatric Emergency Medicine Journal
; : 54-61, 2018.
Article
in English
| WPRIM (Western Pacific)
| ID: wpr-741807
Responsible library:
WPRO
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.
Full text:
Available
Health context:
Neglected Diseases
Health problem:
Diarrhea
/
Neglected Diseases
Database:
WPRIM (Western Pacific)
Main subject:
Pediatrics
/
Appendicitis
/
Vomiting
/
Logistic Models
/
ROC Curve
/
Decision Support Techniques
/
Sensitivity and Specificity
/
Diagnosis
/
Diarrhea
/
Emergency Service, Hospital
Type of study:
Diagnostic study
/
Observational study
/
Prognostic study
/
Risk factors
Limits:
Child
/
Humans
Language:
English
Journal:
Pediatric Emergency Medicine Journal
Year:
2018
Document type:
Article