用于识别因急性腹痛到急诊科就诊儿童急性阑尾炎的小儿阑尾炎评分

Pediatric Appendicitis Score for Identifying Acute Appendicitis in Children Presenting With Acute Abdominal Pain to the Emergency Department.

作者信息

Salahuddin Syed Maaz, Ayaz Omair, Jaffer Mehtab, Naeem Rubaba, Tikmani Shiyam Sundar, Mian Asad I

机构信息

Department of Emergency Medicine, Aga Khan University, Karachi, Pakistan. Correspondence to: Dr Syed Maaz Salahuddin, Instructor, Department of Emergency Medicine, Aga Khan University, Karachi, Pakistan.

Department of Emergency Medicine, Aga Khan University, Karachi, Pakistan.

出版信息

Indian Pediatr. 2022 Oct 15;59(10):774-777. Epub 2022 Aug 10.

PMID:35959758

Abstract

OBJECTIVE

To determine the diagnostic accuracy of Pediatric Appendicitis Score (PAS) in predicting appendicitis in children presenting with acute abdominal pain to the Emergency Department (ED) of a private hospital in Pakistan.

METHODS

This validation study was through retrospective chart review of children between 4-18 years of age with clinical suspicion of acute appendicitis, presenting to the pediatric ED. Diagnostic accuracy was determined using sensitivity, specificity, predictive values, and area under the curve (AUC).

RESULTS

104 children (76% boys) with mean (SD) age of 10.9 (3.5) years met the eligibility criteria. 91% (n=95) patients had moderate to high PAS (score ³4), and 95% (n=99) had biopsy-proven appendicitis. The likelihood ratio calculated for low, equivocal and high-risk PAS was 0.10, 2.17 and 2.53, respectively. An equivocal PAS (score 4-6) showed a sensitivity of 96.8%, specificity of 80%, positive predictive value of 98.9% and AUC of 0.84 for predicting acute appendicitis.

CONCLUSION

PAS showed good diagnostic accuracy in predicting acute appendicitis in children presenting to the ED.

摘要

目的

确定小儿阑尾炎评分（PAS）在预测巴基斯坦一家私立医院急诊科因急性腹痛就诊儿童阑尾炎方面的诊断准确性。

方法

这项验证性研究通过对4至18岁临床怀疑急性阑尾炎且到儿科急诊科就诊的儿童进行回顾性病历审查。使用敏感性、特异性、预测值和曲线下面积（AUC）来确定诊断准确性。

结果

104名儿童（76%为男孩）符合纳入标准，平均（标准差）年龄为10.9（3.5）岁。91%（n = 95）的患者PAS为中度至高度（评分≥4），95%（n = 99）经活检证实为阑尾炎。低、可疑和高风险PAS的似然比分别为0.10、2.17和2.53。可疑PAS（评分4 - 6）在预测急性阑尾炎时，敏感性为96.8%，特异性为80%，阳性预测值为98.9%，AUC为0.84。