Usefulness of the pediatric appendicitis score for assessing the severity of acute appendicitis in children

Abstract

Background: We investigated relationships between the Pediatric Appendicitis Score (PAS) and pathological progression and disease severity in pediatric acute appendicitis. Methods: We retrospectively evaluated 72 children who underwent surgery for acute appendicitis. We divided them into groups: simple appendicitis (n = 28) or complicated appendicitis (n = 44). We compared the influence of age, body temperature, blood test findings, hospitalization period, number of complications, and PAS between the groups. We calculated the sensitivity, specificity, positive predictive value, and negative predictive value of the PAS for diagnosing complicated appendicitis. A receiver operating characteristic curve was constructed to evaluate the cut-off value for diagnosing complicated appendicitis. To assess the severity of acute appendicitis, we divided the patients into groups according to that cut-off value. Results: There were statistically significant differences in the PAS between simple appendicitis and complicated appendicitis (5.8 versus 7.9). The receiver operating characteristic curve indicated a PAS cut-off value of 8. A PAS ≥ 8 had a sensitivity of 73%, a specificity of 89%, a positive predictive value of 91%, and a negative predictive value of 68%. A PAS ≥ 8 was associated with significantly longer hospitalization and more complications than a PAS < 8. Conclusions: The PAS may be associated with pathological progression and disease severity in appendicitis.

Systematic review and meta-analysis of the effects of the perioperative enhanced recovery after surgery concept on the surgical treatment of acute appendicitis in children

“…The ERAS concept has emerged on this basis (13)(14)(15). ERAS takes the patient as the center, adopts the optimized perioperative treatment, alleviates the stress response caused by surgery, reduces the postoperative complication rate, and reduces the length of hospital stay, thus achieving the aim of rapid recovery (16)(17)(18). ERAS involves a combination of rehabilitation, surgery, anesthesia, nursing, and other disciplines to optimize routine perioperative treatment (19).…”

Combining Ultrasound with a Pediatric Appendicitis Score to Distinguish Complicated from Uncomplicated Appendicitis in a Pediatric Population

“…Research by Fujii et al also concludes that a PAS is related to inflammatory appendiceal complications in children with a ROC chart showing a cutoff value of 8 points and AUC of 0.87. PAS ≥ 8 to identify complicated appendicitis with a sensitivity of 73%, the specificity of 89%, the positive predictive value of 91%, and negative predictive value of 68% ( 28 ). Adibe and colleagues also concluded that PAS may be a prognostic tool for acute appendicitis in children in which PAS ≥ 9 can predict severe appendicitis ( 29 ).…”

Value of laboratory investigation data for the diagnostic of acute appendicitis in children

“…На жаль, рівень СРП залежить від тривалості захворювання, а його прогностична значущість недостатня для діагностики ускладнених форм ГА [2,12]. Прогностичні критерії, що достатньо часто використовують для діагностики ГА у дітей, мають достатньо низьку специфічність та чутливість і не можуть передбачити розвиток ускладнених форм ГА [10,22].…”