Prospective validation of the Pediatric Appendicitis Score
Prospective validation of the Pediatric Appendicitis Score
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DOI：
10.1016/j.jpeds.2008.01.033
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发表时间：
2008-08-01
影响因子：
5.1
通讯作者：
Langer, Jacob C.
中科院分区：
文献类型：
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作者：
Goldman, Ran D.;Carter, Susan;Langer, Jacob C.
目的 前瞻性验证儿童阑尾炎评分（PAS）。研究设计 在 19 个月的时间里，我们前瞻性地招募了 1 至 17 岁的儿童，他们来到我们的三级儿科急诊科，主诉持续时间不超过 7 天的腹痛。 PAS 组成部分包括发烧 >38 摄氏度、厌食、恶心/呕吐、咳嗽/叩击/跳跃压痛（2 分）。右下腹压痛（2分）、疼痛迁移、白细胞增多>10 000个细胞/mm(3)、多形核中性粒细胞增多>7500个细胞/mm(3)。进行了后续电话核实最终结果。计算了 PAS 诊断阑尾炎的敏感性、特异性和受试者工作特征曲线。结果 我们收集了 849 名儿童的数据。 123 名 (14.5%) 患有经病理研究证实的阑尾炎。患有阑尾炎和未患阑尾炎的儿童的平均分（中位范围）分别为 7.0 (7, 2-10) 和 1.9 (1, 0-9)。分别。如果使用 PAS = 7 的截止值将儿童带入手术室而无需进一步调查。只有 29 人 (4%) 不会患有阑尾炎。对于 PAS，接受者操作曲线下面积为 0.95。结论 PAS 很有用，因为值 = 7（在 61% 的阑尾炎儿童中发现）对于预测阑尾炎的存在具有很高的有效性。 PAS 为 3 至 6 的儿童（本研究中 37% 患有阑尾炎，23% 没有阑尾炎）应接受进一步的检查，即观察。超声检查或计算机断层扫描。
Objective To prospectively validate the Pediatric Appendicitis Score (PAS). developed on a cohort of children with abdominal pain suggestive of appendicitis, in unselected children with abdominal pain who present to the emergency department.Study design Over a 19-month period, we prospectively recruited children I to 17 years old who came to our tertiary pediatric emergency department, with a chief complaint of abdominal pain of duration less than 7 days. PAS components included fever >38 degrees C, anorexia nausea/vomiting, cough/percussion/hopping tenderness (2 points). right-lower-quadrant tenderness (2 points), migration of pain, leukocytosis >10 000 cells/mm(3), and polymorphonuclear neutrophilia > 7500 cells/mm(3). A follow-up call was made to verify final outcome. Sensitivity, specificity, and the receiver operating characteristic curve of the PAS with respect to diagnosis of appendicitis were calculated.Results We collected data on 849 children. 123 (14.5%) had pathologic study-proven appendicitis. Mean (median. range) score for children with appendicitis and without appendicitis was 7.0 (7, 2-10) and 1.9 (1, 0-9). respectively. If a cutoff PAS of = 7 was used to take children to the operating room without further investigation. only 29 (4%) would not have appendicitis. For the PAS the area under the receiver operator curve was 0.95.Conclusions The PAS is useful, because a value = 7 (found in 61% of children with appendicitis) has a high validity for predicting the presence of appendicitis. Children with PAS of 3 to 6 (37% with appendicitis and 23% without appendicitis in this study) should undergo further investigation such;is observation. ultrasonography, or computed tomography.