Usefulness of the pediatric appendicitis score for assessing the severity of acute appendicitis in children
Usefulness of the pediatric appendicitis score for assessing the severity of acute appendicitis in children
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DOI：
10.1111/ped.14032
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发表时间：
2020-01-01
影响因子：
1.4
通讯作者：
Shimono, Ryuichi
中科院分区：
文献类型：
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作者：
Fujii, Takayuki;Tanaka, Aya;Shimono, Ryuichi
背景我们研究了小儿阑尾炎评分（PAS）与小儿急性阑尾炎的病理进展和疾病严重程度之间的关系。方法回顾性分析72例急性阑尾炎手术患儿的临床资料。我们将其分为两组：单纯性阑尾炎（n = 28）和复杂性阑尾炎（n = 44）。我们比较了年龄、体温、血液检查结果、住院时间、并发症数量和PAS对两组的影响。我们计算PAS诊断复杂性阑尾炎的敏感性、特异性、阳性预测值和阴性预测值。建立受试者工作特征曲线，以评估诊断复杂性阑尾炎的临界值。为了评估急性阑尾炎的严重程度，我们根据临界值将患者分组。结果单纯性阑尾炎与复杂性阑尾炎的PAS值分别为5.8和7.9，差异有统计学意义。接收器操作特征曲线表明PAS截止值为8。PAS ≥ 8的敏感性为73%，特异性为89%，阳性预测值为91%，阴性预测值为68%。PAS >= 8与PAS < 8相比，住院时间明显延长，并发症更多。结论PAS可能与阑尾炎的病理进展和病情严重程度有关。
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.