Mujica-Guevara JA, Pierdant-Pérez M, Gordillo-Moscoso AA, Martínez-Martínez MU, Ramírez-Meléndez R

Language: Spanish
References: 21
Page: 209-215
PDF size: 463.10 Kb.

ABSTRACT

Introduction: Acute appendicitis is the leading cause of abdominal surgery in children. It is sometimes difficult to distinguish appendicitis from other conditions, which can lead to delayed diagnosis. The pediatric score for appendicitis and the Lintula score are scoring systems based on the presence or absence of symptoms and signs that have been validated in the pediatric population. There are no prospective studies in the same population group that would inform us which would be most useful in evaluating the child with suspected appendicitis.
Objectives: The purpose of this study was to compare the results of the Lintula (SL) and Pediatric Appendicitis Score (PAS) systems and to establish the best score foracute appendicitisdiagnosis in children.
Methods: We prospectively evaluated children of 4 to 15 years old with abdominal pain and suspected appendicitis who were admitted to the pediatric emergency department of a secondarylevel hospital, in the period from February to August 2015. Both scores were rated in each patient, definitive diagnosis was pathological or the follow up.
Results: 100 patients were included, 47% confirmed appendicitis. LS average in patients without appendicitis was 12.5 (SD 6.2) and 28.8 (SD 5.2) for appendicitis cases. (p‹0.001). The PAS average score was 4.3 (SD 2.1) for patients without appendicitis and 8.3 (SD 1.5) for appendicitis cases (p ‹0.001). Based on the ROC curve analysis, the best cutoff point was 20 for SL and 6 for PAS. SL sensitivity was 89.4%, specificity 90.6%. AUC 0.942. PAS yielded 95.7%, specificity 75.5% sensitivity. AUC 0.924. We found no significant differences between both scores.
Conclusions: Both scores have an appropriate sensitivity and specificity;therefore, its use should be encouraged in the evaluation of children with suspected appendicitis in our population.

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