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Comparison of Appendicitis Scoring Systems in Pediatric Patients

Yıl 2021, Cilt 11, Sayı 4, 510 - 514, 31.07.2021
https://doi.org/10.16899/jcm.876825

Öz

BACKGROUND: Acute appendicitis is one of the most common causes of emergency department (ED) admission among pediatric patients, and the most common cause of abdominal pain requiring surgical intervention. The present study aimed to measure the success of three different appendicitis scoring systems in patients who were operated due to acute appendicitis (AA) upon presenting at the pediatric ED with acute abdominal pain. METHODS: The study included a total of 226 patients who were admitted to Pediatric Emergency Department and who underwent an appendectomy between December 2018 and May 2019. Through a retrospective review of patient files; age, gender, clinical findings, laboratory results, Pediatric Appendicitis Score (PAS), Lintula score, Acute Inflammatory Response (AIR) score, ultrasonography (USG) findings and pathology results of the patients operated due to AA were recorded. RESULTS: A total of 226 patients were included in the study, with a mean age of 11.6±3.66 (1-17) years, and 57.1% (n=129) of the patients were female and 42.9% (n=97) were male. The pathology results were evaluated under three categories: suppurative (phlegmonous) appendicitis, 74.3%; perforated appendix, 9.7%; and reactive lymphoid hyperplasia, 15.9%. The cut-off values >3 for AIR, >7 for PAS and >15 for Lintula were found statistically significant. Among the three scoring systems, Lintula had the highest sensitivity (91.5%) and PAS had the highest specificity (69.4%). DISCUSSION:Although scoring systems are used to diagnose AA, the selected cut-off values for the scoring systems have an effect on the results.. Patients with a PAS score of ≥7 were found to have more significant AA results. We believe that PAS is likely to be a preferred scoring system in pediatric patients, especially under busy ED conditions; however, further studies with larger populations are needed to develop scoring systems that will guide physicians to establish a final diagnosis.

Kaynakça

  • 1. Sivit C.J, et al. When appendicitis is suspected in children. Radiographics 2001. 21(1): 247-62; questionnaire 288-94. 2. Blakely ML,Williams R, Dassinger MS, Eubanks JW 3rd, Fischer P, Huang EY, et al. Early vs interval appandectomy for urg 2011;146:660-5.

Comparison of Appendicitis Scoring Systems in Pediatric Patients

Yıl 2021, Cilt 11, Sayı 4, 510 - 514, 31.07.2021
https://doi.org/10.16899/jcm.876825

Öz

BACKGROUND: Acute appendicitis is one of the most common causes of emergency department (ED) admission among pediatric patients, and the most common cause of abdominal pain requiring surgical intervention. The present study aimed to measure the success of three different appendicitis scoring systems in patients who were operated due to acute appendicitis (AA) upon presenting at the pediatric ED with acute abdominal pain. METHODS: The study included a total of 226 patients who were admitted to Pediatric Emergency Department and who underwent an appendectomy between December 2018 and May 2019. Through a retrospective review of patient files; age, gender, clinical findings, laboratory results, Pediatric Appendicitis Score (PAS), Lintula score, Acute Inflammatory Response (AIR) score, ultrasonography (USG) findings and pathology results of the patients operated due to AA were recorded. RESULTS: A total of 226 patients were included in the study, with a mean age of 11.6±3.66 (1-17) years, and 57.1% (n=129) of the patients were female and 42.9% (n=97) were male. The pathology results were evaluated under three categories: suppurative (phlegmonous) appendicitis, 74.3%; perforated appendix, 9.7%; and reactive lymphoid hyperplasia, 15.9%. The cut-off values >3 for AIR, >7 for PAS and >15 for Lintula were found statistically significant. Among the three scoring systems, Lintula had the highest sensitivity (91.5%) and PAS had the highest specificity (69.4%). DISCUSSION:Although scoring systems are used to diagnose AA, the selected cut-off values for the scoring systems have an effect on the results.. Patients with a PAS score of ≥7 were found to have more significant AA results. We believe that PAS is likely to be a preferred scoring system in pediatric patients, especially under busy ED conditions; however, further studies with larger populations are needed to develop scoring systems that will guide physicians to establish a final diagnosis.

Kaynakça

  • 1. Sivit C.J, et al. When appendicitis is suspected in children. Radiographics 2001. 21(1): 247-62; questionnaire 288-94. 2. Blakely ML,Williams R, Dassinger MS, Eubanks JW 3rd, Fischer P, Huang EY, et al. Early vs interval appandectomy for urg 2011;146:660-5.

Ayrıntılar

Birincil Dil İngilizce
Konular Sağlık Bilimleri ve Hizmetleri
Bölüm Orjinal Araştırma
Yazarlar

İlknur BANLI CESUR (Sorumlu Yazar)
UNIVERSITY OF HEALTH SCIENCES, ADANA NUMUNE HEALTH RESEARCH CENTER, DEPARTMENT OF SURGICAL MEDICAL SCIENCES
0000-0001-5263-5786
Türkiye


Sinem SARI GÖKAY
ADANA NUMUNE SAĞLIK UYGULAMA VE ARAŞTIRMA MERKEZİ
0000-0002-8585-1626
Türkiye

Destekleyen Kurum yok
Yayımlanma Tarihi 31 Temmuz 2021
Kabul Tarihi 24 Mart 2021
Yayınlandığı Sayı Yıl 2021, Cilt 11, Sayı 4

Kaynak Göster

AMA Banlı Cesur İ. , Sarı Gökay S. Comparison of Appendicitis Scoring Systems in Pediatric Patients. J Contemp Med. 2021; 11(4): 510-514.