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Predictive inflammatory parameters in the diagnosis of acute appendicitis in children

Han-Ping Wu1, Chin-Fu Chang, Ching-Yuang Lin

  • 1Department of Emergency Medicine, Changhua Christian Hospital, 135 Nanshsiao Street, Changhua 500, Taiwan.

Acta Paediatrica Taiwanica = Taiwan Er Ke Yi Xue Hui Za Zhi
|December 17, 2003
PubMed

Insights

Elevated neutrophil count and C-reactive protein levels are key indicators for early diagnosis of acute appendicitis in children. These factors, alongside leukocytosis, improve diagnostic accuracy in pediatric surgical emergencies.

Area of Science:

  • Pediatric Surgery
  • Clinical Diagnostics
  • Biomarkers

Background:

  • Acute appendicitis is the most frequent abdominal surgical emergency in pediatric patients.
  • Accurate and timely diagnosis is crucial to minimize complications and negative appendicectomy rates.

Purpose of the Study:

  • To identify factors associated with the early diagnosis of acute appendicitis in children.
  • To evaluate the diagnostic utility of specific laboratory parameters.

Main Methods:

  • Retrospective analysis of hospital records for 260 pediatric patients (<18 years) operated on for suspected appendicitis.
  • Statistical analysis including multivariate logistic regression to determine significant predictive factors.
  • Evaluation of diagnostic accuracy, specificity, and positive predictive value of combined biomarkers.

Main Results:

  • The overall accurate diagnosis rate for acute appendicitis was 81.5%, with a negative appendicectomy rate of 18.5%.
  • Elevated neutrophil count (Odds Ratio = 3.79) and elevated C-reactive protein (Odds Ratio = 2.81) were significantly associated with acute appendicitis.
  • Combining leukocytosis, elevated neutrophils, and elevated C-reactive protein enhanced diagnostic specificity and positive predictive value.

Conclusions:

  • Total neutrophil count and C-reactive protein concentration are valuable predictive parameters for the early diagnosis of acute appendicitis in children.
  • These biomarkers can aid clinicians in improving diagnostic accuracy for pediatric appendicitis.
  • Further research may focus on refining diagnostic algorithms incorporating these inflammatory markers.

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