Pediatric appendicitis score.
OBJECTIVE
Morbidity in children treated with appendicitis results either from late diagnosis or negative appendectomy. A Prospective analysis of efficacy of Pediatric Appendicitis Score for early diagnosis of appendicitis in children was conducted.


METHODS
In the last 5 years, 1,170 children aged 4 to 15 years with abdominal pain suggestive of acute appendicitis were evaluated prospectively. Group 1 (734) were patients with appendicitis and group 2 (436) nonappendicitis. Multiple linear logistic regression analysis of all clinical and investigative parameters was performed for a model comprising 8 variables to form a diagnostic score.


RESULTS
Logistic regression analysis yielded a model comprising 8 variables, all statistically significant, P <.001. These variables in order of their diagnostic index were (1) cough/percussion/hopping tenderness in the right lower quadrant of the abdomen (0.96), (2) anorexia (0.88), (3) pyrexia (0.87), (4) nausea/emesis (0.86), (5) tenderness over the right iliac fossa (0.84), (6) leukocytosis (0.81), (7) polymorphonuclear neutrophilia (0.80) and (8) migration of pain (0.80). Each of these variables was assigned a score of 1, except for physical signs (1 and 5), which were scored 2 to obtain a total of 10. The Pediatric Appendicitis Score had a sensitivity of 1, specificity of 0.92, positive predictive value of 0.96, and negative predictive value of 0.99.


CONCLUSIONS
Pediatric appendicitis score is a simple, relatively accurate diagnostic tool for accessing an acute abdomen and diagnosing appendicitis in children.
Samuel
Madan
M
Department of Pediatric Urology, Great Ormond Street Hospital for Children NHS Trust, London, England.
D015746:Abdominal Pain / Q000145:classification*; D000208:Acute Disease; D000293:Adolescent; D001063:Appendiceal Neoplasms / Q000209:etiology / Q000473:pathology / Q000601:surgery; D001064:Appendicitis / Q000175:diagnosis*; D002648:Child; D002675:Child, Preschool; D003937:Diagnosis, Differential; D005260:Female; D005767:Gastrointestinal Diseases / Q000175:diagnosis; D006801:Humans; D016015:Logistic Models; D008297:Male; D008467:Meckel Diverticulum / Q000175:diagnosis; D010048:Ovarian Cysts / Q000175:diagnosis; D010195:Pancreatitis / Q000175:diagnosis; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012141:Respiratory Tract Infections / Q000175:diagnosis; D012422:Rupture, Spontaneous; D012680:Sensitivity and Specificity