TY - JOUR
T1 - A scoring system to predict the severity of appendicitis in children
AU - Gorter, Ramon R.
AU - van den Boom, Anne Loes
AU - Heij, Hugo A.
AU - Kneepkens, C. M. Frank
AU - Hulsker, Caroline C.
AU - Tenhagen, Mark
AU - Dawson, Imro
AU - van der Lee, Johanna H.
PY - 2016/2
Y1 - 2016/2
N2 - It appears that two forms of appendicitis exist. Preoperative distinction between the two is essential to optimize treatment outcome. This study aimed to develop a scoring system to accurately determine the severity of appendicitis in children. Historical cohort study of pediatric patients (aged 0-17 y old) with appendicitis treated between January 2010 and December 2012. Division into simple, complex appendicitis, or another condition based on preset criteria. Multiple logistic regression analysis was used to build the prediction model with subsequent validation. There were 64 patients with simple and 66 with complex appendicitis. Five variables explained 64% of the variation. Independent validation of the derived prediction model in a second cohort (55 simple and 10 complex appendicitis patients) demonstrated 90% sensitivity (54-99), 91% specificity (79-97), a positive predictive value of 64% (36-86), and an negative predictive value of 98% (88-100). The likelihood ratio+ was 10 (4.19-23.42), and likelihood ratio- was 0.11 (0.02-0.71). Diagnostic accuracy was 91% (84-98). Our scoring system consisting of five variables can be used to exclude complex appendicitis in clinical practice if the score is <4
AB - It appears that two forms of appendicitis exist. Preoperative distinction between the two is essential to optimize treatment outcome. This study aimed to develop a scoring system to accurately determine the severity of appendicitis in children. Historical cohort study of pediatric patients (aged 0-17 y old) with appendicitis treated between January 2010 and December 2012. Division into simple, complex appendicitis, or another condition based on preset criteria. Multiple logistic regression analysis was used to build the prediction model with subsequent validation. There were 64 patients with simple and 66 with complex appendicitis. Five variables explained 64% of the variation. Independent validation of the derived prediction model in a second cohort (55 simple and 10 complex appendicitis patients) demonstrated 90% sensitivity (54-99), 91% specificity (79-97), a positive predictive value of 64% (36-86), and an negative predictive value of 98% (88-100). The likelihood ratio+ was 10 (4.19-23.42), and likelihood ratio- was 0.11 (0.02-0.71). Diagnostic accuracy was 91% (84-98). Our scoring system consisting of five variables can be used to exclude complex appendicitis in clinical practice if the score is <4
KW - Appendicitis
KW - Clinical prediction rule
KW - Complex appendicitis
KW - Scoring system
U2 - https://doi.org/10.1016/j.jss.2015.08.042
DO - https://doi.org/10.1016/j.jss.2015.08.042
M3 - Article
C2 - 26434504
SN - 0022-4804
VL - 200
SP - 452
EP - 459
JO - Journal of Surgical Research
JF - Journal of Surgical Research
IS - 2
ER -