Guo Li-Ming, Jiang Zhi-Hui, Liu Hong-Zhen
Department of General Surgery, Qingdao Women and Children's Hospital, Qingdao 266000, Shandong Province, China.
Department of Pediatric Surgery, Children's Hospital Affiliated to Shandong University, Jinan 250022, Shandong Province, China.
World J Gastrointest Surg. 2024 Aug 27;16(8):2565-2573. doi: 10.4240/wjgs.v16.i8.2565.
Pediatric appendicitis is a common cause of abdominal pain in children and is recognized as a significant surgical emergency. A prompt and accurate diagnosis is essential to prevent complications such as perforation and peritonitis.
To investigate the predictive value of the systemic immune-inflammation index (SII) combined with the pediatric appendicitis score (PAS) for the assessment of disease severity and surgical outcomes in children aged 5 years and older with appendicitis.
Clinical data of 104 children diagnosed with acute appendicitis were analyzed. The participants were categorized into the acute appendicitis group and chronic appendicitis group based on disease presentation and further stratified into the good prognosis group and poor prognosis group based on prognosis. The SII and PAS were measured, and a joint model using the combined SII and PAS was constructed to predict disease severity and surgical outcomes.
Significant differences were observed in the SII and PAS parameters between the acute appendicitis group and chronic appendicitis group. Correlation analysis showed associations among the SII, PAS, and disease severity, with the combined SII and PAS model demonstrating significant predictive value for assessing disease severity [aera under the curve (AUC) = 0.914] and predicting surgical outcomes (AUC = 0.857) in children aged 5 years and older with appendicitis.
The study findings support the potential of integrating the SII with the PAS for assessing disease severity and predicting surgical outcomes in pediatric appendicitis, indicating the clinical utility of the combined SII and PAS model in guiding clinical decision-making and optimizing surgical management strategies for pediatric patients with appendicitis.
小儿阑尾炎是儿童腹痛的常见原因,被视为重大外科急症。及时准确的诊断对于预防诸如穿孔和腹膜炎等并发症至关重要。
探讨全身免疫炎症指数(SII)联合小儿阑尾炎评分(PAS)对5岁及以上阑尾炎患儿疾病严重程度及手术结局评估的预测价值。
分析104例诊断为急性阑尾炎患儿的临床资料。根据疾病表现将参与者分为急性阑尾炎组和慢性阑尾炎组,并根据预后进一步分为预后良好组和预后不良组。测量SII和PAS,并构建使用联合SII和PAS的联合模型以预测疾病严重程度和手术结局。
急性阑尾炎组和慢性阑尾炎组在SII和PAS参数上存在显著差异。相关性分析显示SII、PAS与疾病严重程度之间存在关联,联合SII和PAS模型对5岁及以上阑尾炎患儿的疾病严重程度评估 [曲线下面积(AUC)= 0.914] 和手术结局预测(AUC = 0.857)具有显著预测价值。
研究结果支持将SII与PAS整合用于评估小儿阑尾炎疾病严重程度和预测手术结局的潜力,表明联合SII和PAS模型在指导临床决策和优化小儿阑尾炎患者手术管理策略方面的临床实用性。