Applying the Pediatric Appendicitis Score to predict complicated appendicitis in children

Area of Science:

• Pediatric Surgery
• Emergency Medicine
• Diagnostic Accuracy

Background:

• Acute appendicitis is common in children.
• Accurate prediction of complicated appendicitis (CA) is crucial for timely intervention.
• Existing diagnostic tools require further validation.

Purpose of the Study:

• To evaluate the efficacy of the Pediatric Appendicitis Score (PAS).
• To identify key indicators for predicting complicated appendicitis in children.
• To assess the combined diagnostic performance of various predictors for CA.

Main Methods:

• Retrospective cohort study of 161 pediatric patients with acute appendicitis (2008-2020).
• Collection of demographic, symptomatic, physical, laboratory data, and PAS.
• Multivariate analysis and ROC curve analysis to identify CA predictors.

Main Results:

• Symptom duration >1 day, CRP > 4 mg/dL, and PAS ≥ 8 were significant predictors of CA.
• Combined predictors achieved an AUC of 0.91.
• The combination demonstrated high specificity (99%) and PPV (98%) for CA.

Conclusions:

• Symptom duration, CRP levels, and PAS are valuable predictors of CA in children.
• The PAS enhances CA prediction when used with symptom duration and CRP.
• This combined approach improves diagnostic accuracy for pediatric appendicitis.