Department of Surgery, Kuopio University Hospital and School of Medicine, University of Eastern Finland, Kuopio, Finland.
Molecular Oncology Research Center, Barretos Cancer Hospital, Barretos, Brazil.
Anticancer Res. 2021 Jan;41(1):297-306. doi: 10.21873/anticanres.14776.
The aim of the study was to compare the accuracy of common clinical findings, laboratory tests and diagnostic score (DS) in diagnosis of clinically confirmed acute appendicitis (AA) in children.
A cohort of 188 children under the age of 15 years presenting with acute abdominal pain (AAP) were included in the study. The clinical history (n=21), signs (n=14) and tests (n=3) were recorded in each child.
The significant independent diagnostic predictors (disclosed by multivariate logistic regression model) were used to construct the DS formulas for AA diagnosis. These formulas were tested at six different cut-off levels to establish the most optimal diagnostic performance for clinically confirmed AA. In the receiver operating characteristic curve (ROC) comparison test, there was a statistically significant difference (p=0.0055) in the area under curve (AUC) values between i) clinical history and symptoms (AUC=0.594), and ii) signs and laboratory tests (AUC=0.734), whereas both were significantly inferior (p=0.0001) to the AUC value of the DS (AUC=0.952).
In diagnosis of clinically confirmed AA in children, the DS formula is superior to both the clinical history/symptoms and signs/lab tests, justifying the use of DS as an integral part of the diagnostic algorithm of AA in all children presenting with AAP.
本研究旨在比较常见临床特征、实验室检查和诊断评分（DS）在诊断儿童经临床确诊的急性阑尾炎（AA）中的准确性。
本研究纳入了 188 名年龄在 15 岁以下、出现急性腹痛（AAP）的儿童。对每位儿童记录了临床病史（n=21）、体征（n=14）和检查（n=3）。
通过多变量逻辑回归模型揭示了显著的独立诊断预测因素，用于构建 AA 诊断的 DS 公式。这些公式在六个不同的截断水平进行了测试，以确定对经临床确诊的 AA 的最佳诊断性能。在受试者工作特征曲线（ROC）比较测试中，临床病史和症状（AUC=0.594）与体征和实验室检查（AUC=0.734）之间的曲线下面积（AUC）值存在统计学差异（p=0.0055），而两者均明显低于 DS（AUC=0.952）的 AUC 值（p=0.0001）。
在诊断儿童经临床确诊的 AA 中，DS 公式优于临床病史/症状和体征/实验室检查，证明 DS 可作为所有出现 AAP 的儿童 AA 诊断算法的一个组成部分。
