title: [Appendicitis versus non-specific acute abdominal pain: Paediatric Appendicitis Score evaluation].
abstract: BACKGROUND
  Non-specific acute abdominal pain is the most common process requiring differential diagnosis with appendicitis in clinical practice. The aim of this study was to assess the Paediatric Appendicitis Score in differentiating between these two entities.
  
  
  METHODS
  All patients admitted due to suspicion of appendicitis were prospectively evaluated in our hospital over a two-year period. Cases of non-specific acute abdominal pain and appendicitis were enrolled in the study. Several variables were collected, including Score variables and C-reactive protein levels. Descriptive, univariate and multivariate analyses and diagnostic accuracy studies (ROC curves) were performed.
  
  
  RESULTS
  A total of 275 patients were studied, in which there were 143 cases of non-specific acute abdominal pain and 132 cases of appendicitis. Temperature and right iliac fossa tenderness on palpation were the variables without statistically significant differences, and with no discrimination power between groups. Pain on coughing, hopping, and/or percussion tenderness in the right lower quadrant was the variable with greater association with appendicitis. The Score correctly stratified the patients into risk groups. Substitution of temperature for C-reactive protein in the Score increased diagnostic accuracy, although with no statistically significant differences.
  
  
  CONCLUSIONS
  The Paediatric Appendicitis Score helps in differential diagnosis between appendicitis and non-specific acute abdominal pain. It would be advisable to replace the temperature in the Score, since it has no discrimination power between these groups. C-reactive protein at a cut-off value of 25.5mg/L value could be used instead.
authors.affiliation: Sección de Cirugía Pediátrica, Hospital Universitario Álvaro Cunqueiro, Vigo, Pontevedra, España; Instituto de Investigación Sanitaria Galicia Sur, Hospital Universitario Álvaro Cunqueiro, Vigo, Pontevedra, España. Electronic address: marcospradaarias@gmail.com.
authors.forename: Marcos
authors.initials: M
authors.lastname: Prada Arias
authors.affiliation: Unidad de apoyo a la Investigación, Hospital Universitario Álvaro Cunqueiro, Vigo, Pontevedra, España; Instituto de Investigación Sanitaria Galicia Sur, Hospital Universitario Álvaro Cunqueiro, Vigo, Pontevedra, España.
authors.forename: Angel
authors.initials: A
authors.lastname: Salgado Barreira
authors.affiliation: Sección de Cirugía Pediátrica, Hospital Universitario Álvaro Cunqueiro, Vigo, Pontevedra, España; Instituto de Investigación Sanitaria Galicia Sur, Hospital Universitario Álvaro Cunqueiro, Vigo, Pontevedra, España.
authors.forename: Margarita
authors.initials: M
authors.lastname: Montero Sánchez
authors.affiliation: Sección de Cirugía Pediátrica, Hospital Universitario Álvaro Cunqueiro, Vigo, Pontevedra, España; Instituto de Investigación Sanitaria Galicia Sur, Hospital Universitario Álvaro Cunqueiro, Vigo, Pontevedra, España.
authors.forename: Pilar
authors.initials: P
authors.lastname: Fernández Eire
authors.affiliation: Sección de Cirugía Pediátrica, Hospital Universitario Álvaro Cunqueiro, Vigo, Pontevedra, España.
authors.forename: Silvia
authors.initials: S
authors.lastname: García Saavedra
authors.affiliation: Sección de Cirugía Pediátrica, Hospital Universitario Álvaro Cunqueiro, Vigo, Pontevedra, España.
authors.forename: Javier
authors.initials: J
authors.lastname: Gómez Veiras
authors.affiliation: Servicio de Pediatría, Hospital Universitario Álvaro Cunqueiro, Vigo, Pontevedra, España; Instituto de Investigación Sanitaria Galicia Sur, Hospital Universitario Álvaro Cunqueiro, Vigo, Pontevedra, España.
authors.forename: José Ramón
authors.initials: JR
authors.lastname: Fernández Lorenzo
mesh_terms: D000006:Abdomen, Acute / Q000175:diagnosis*; D001064:Appendicitis / Q000175:diagnosis*; D002648:Child; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008297:Male; D011446:Prospective Studies
keywords: Apendicitis; Appendicitis; C-reactive protein; Child; Clinical prediction rule; Diagnosis; Diagnóstico; Dolor abdominal agudo inespecífico; Niño; Non-specific acute abdominal pain; Proteína C reactiva; Regla de predicción clínica