Related Experiment Videos
Prospective validation of the pediatric appendicitis score
Ran D Goldman1, Susan Carter, Derek Stephens
1Department of Pediatrics, Division of Pediatric Emergency Medicine, Pediatric Research in Emergency Therapeutics Program, BC Children's Hospital, University of British Columbia, Vancouver, British Columbia, Canada. rgoldman@cw.bc.ca
The Journal of Pediatrics
|June 7, 2008
Summary
The Pediatric Appendicitis Score (PAS) effectively rules out appendicitis in children with low scores and predicts its presence in those with high scores. Further investigation is recommended for intermediate scores.
Area of Science:
- Pediatric Emergency Medicine
- Diagnostic Accuracy Studies
- Clinical Decision Support Tools
Background:
- Appendicitis is a common surgical emergency in children.
- Accurate diagnosis is crucial to avoid complications and unnecessary surgery.
- The Pediatric Appendicitis Score (PAS) was previously developed to aid in diagnosis.
Purpose of the Study:
- To prospectively validate the Pediatric Appendicitis Score (PAS).
- To assess the utility of PAS in unselected children presenting with abdominal pain to the emergency department.
Main Methods:
- Prospective recruitment of children aged 1-17 years with abdominal pain.
- Data collection on PAS components: fever, anorexia, nausea/vomiting, tenderness characteristics, pain migration, leukocytosis, and neutrophilia.
- Calculation of sensitivity, specificity, and area under the receiver operating characteristic curve (AUC) for PAS.
Main Results:
- 849 children were analyzed; 123 (14.5%) had appendicitis.
- Mean PAS was 7.0 for appendicitis cases and 1.9 for non-appendicitis cases.
- An AUC of 0.95 indicated high diagnostic performance for PAS.
Conclusions:
- A PAS cutoff of <=2 has high validity for ruling out appendicitis.
- A PAS cutoff of >=7 has high validity for predicting appendicitis.
- Children with PAS scores of 3-6 require further investigation (e.g., imaging, observation).
Related Concept Videos
01:22Appendicitis-I: Introduction
The appendix, a small, narrow, blind tube extending from the inferior part of the cecum, is widely regarded as a vestigial organ, having lost much of its original function through evolution. Despite its diminished role, the appendix can become inflamed, a condition known as appendicitis.
Etiology: Appendicitis can arise from various causes, primarily rooted in the obstruction of the appendix lumen. Factors contributing to this obstruction include fecal accumulation, lymphoid hyperplasia and, in...
Etiology: Appendicitis can arise from various causes, primarily rooted in the obstruction of the appendix lumen. Factors contributing to this obstruction include fecal accumulation, lymphoid hyperplasia and, in...
01:29Appendicitis-II: Diagnostic Studies and Management
Diagnosing and managing appendicitis requires a structured and comprehensive approach that spans from initial assessment to postoperative care. Here is an overview of the process:
Diagnosing Appendicitis
It requires a multifaceted approach, starting with a detailed physical examination to pinpoint the location and nature of the pain and identify any associated symptoms. Laboratory tests play a crucial role. A complete Blood Count (CBC) typically reveals leukocytosis (an increased number of...
Diagnosing Appendicitis
It requires a multifaceted approach, starting with a detailed physical examination to pinpoint the location and nature of the pain and identify any associated symptoms. Laboratory tests play a crucial role. A complete Blood Count (CBC) typically reveals leukocytosis (an increased number of...
01:19Appendicitis
Appendicitis is an acute inflammatory condition of the vermiform appendix, most commonly caused by obstruction of its lumen. The appendix is a narrow, blind-ended pouch that extends from the cecum, making it particularly prone to obstruction. Causes include fecaliths, lymphoid hyperplasia (often after viral infections), parasites, tumors, or foreign bodies. This obstruction initiates a cascade of pathological changes.Luminal Obstruction and Early InflammationAfter obstruction, normal mucosal...
01:18Assessment of the Abdomen II: Percussion
Percussion is a fundamental technique used to assess the liver, spleen, and abdominal organs by tapping the abdomen and interpreting the resulting sounds. This method helps identify fluid, distention, and masses through variations in sound, such as the high-pitched tympany of air-filled areas and the dullness of solid masses. Understanding how to percuss these organs provides valuable information for healthcare professionals in diagnosing conditions early.
Percussion
Percussion is an essential...
Percussion
Percussion is an essential...