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A novel diagnostic scoring system for pediatric appendicitis based on age and sex-adjusted hematological parameters
Bahattin Aydoğdu1, Mustafa Azizoğlu1, Serkan Arslan1
1Department of Pediatric Surgery.
Background:
Acute appendicitis diagnosis can sometimes be a real challenge in pediatric patients.
Objective:
To establish the importance of neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), and other hematological parameters adjusted for age and sex in the prediction of acute appendicitis, as well as to describe a new scoring system.
Material And Methods:
Medical records of 946 children hospitalized for acute appendicitis were retrospectively analyzed. A scoring system based on NLR, PLR, lymphocyte/monocyte ratio (LMR), and C-reactive protein (CRP) adjusted for age and sex was developed.
Results:
Patients were divided into group I, with negative examination, and group II, with acute appendicitis; mean ages were 12.20 ± 2.31 and 11.56 ± 3.11, respectively. Leukocyte count, neutrophil percentage, NLR, PLR, LMR and PCR were higher in group II. The scores ranged from 0 to 8 points; 4.5 was determined to be the best cut-off point for acute appendicitis with the highest area under the curve (0.96), sensitivity (94%), specificity (86%), positive predictive value (97.5%), negative predictive value (65%), accuracy (92.6%) and misclassification rate (7.4%).
Conclusion:
The proposed scoring system, calculated based on patient age and gender, can be used for unnecessary surgeries to be avoided.
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