[Appendicitis versus non-specific acute abdominal pain: Paediatric Appendicitis Score evaluation]

Area of Science:

• Pediatric Surgery
• Emergency Medicine
• Diagnostic Accuracy Studies

Background:

• Non-specific acute abdominal pain is a frequent challenge in differentiating from appendicitis.
• Accurate diagnosis is crucial for appropriate patient management and preventing complications.

Purpose of the Study:

• To evaluate the effectiveness of the Paediatric Appendicitis Score in differentiating appendicitis from non-specific acute abdominal pain.
• To identify potential improvements in the score's diagnostic performance.

Main Methods:

• Prospective evaluation of patients with suspected appendicitis over two years.
• Collection of clinical variables, including score components and C-reactive protein levels.
• Statistical analyses including ROC curves to assess diagnostic accuracy.

Main Results:

• 143 cases of non-specific abdominal pain and 132 of appendicitis were analyzed.
• Pain on coughing, hopping, or percussion tenderness showed strong association with appendicitis.
• The Paediatric Appendicitis Score effectively stratified patients by risk. Substituting C-reactive protein for temperature showed potential for increased accuracy.

Conclusions:

• The Paediatric Appendicitis Score is valuable for differentiating appendicitis from non-specific abdominal pain.
• Replacing temperature with C-reactive protein in the score is recommended due to temperature's lack of discriminatory power.
• C-reactive protein at 25.5mg/L may serve as a useful alternative marker.