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ISSN 1561-3119 (Electronic)

2019, Number 4

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Rev Cubana Pediatr 2019; 91 (4)

Diagnostic performance of Alvarado score for acute appendicitis in children

Ramírez GA, Navarro SAB, Gámez FLN

Language: Spanish
References: 25
Page: 1-15
PDF size: 362.98 Kb.


ABSTRACT

Introduction: The diagnosis of acute appendicitis in children is although frequent still challenging and in despite of the higher clinical experience and the more effective laboratory and imaging studies.
Objective: To determine the diagnostic performance of Alvarado score for acute appendicitis in children.
Methods: An observational, analytic and prospective study was conducted on 452 patients aged from 5 to 18 years old whom were admitted to the Pediatric Surgery service of Centro Habana Pediatric Hospital from January 2016 to January 2017 with a diagnosis of abdominal pain or acute appendicitis.
Results: 77.0% of admitted patients had diagnosis of appendicitis. The specificity and positive predictive value of the score were 0.90 and 0.95, respectively, considering 7 as the cutoff point; however, the sensitivity, the negative predictive value and the diagnostic accuracy had low values. The most balanced cutoff point was determined to be 6. Only 3 positive cases had scores under 4. The area under the Receiver Operating Characteristics Curve was 0.85.
Conclusions: The score had good specificity and positive predictive value, as well as an acceptable general discriminative performance. However, it didn’t result appropriate as a unique tool for diagnosing acute appendicitis in the clinical setting. Nevertheless, it would be useful for ruling out the condition with a high level of certainty.


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