Application of a clinical score for the diagnosis of acute appendicitis in childhood: a retrospective analysis of 197 patients

J Pediatr Surg. 2000 Sep;35(9):1320-2. doi: 10.1053/jpsu.2000.9316.

Abstract

Purpose: The aim of this study was to validate a clinical scoring system for the diagnosis of acute appendicitis in childhood.

Methods: The authors retrospectively applied a clinical scoring system on 197 consecutive pediatric patients operated on for acute appendicitis. They therefore looked for a correlation between the management suggested by the scoring system and pathologic diagnosis on surgical specimens.

Results: Based on final pathologic specimen, surgery has been performed unnecessarily in 23% of cases. The proposed scoring system could have reduced unnecessary surgery to 2%. Only 8% of patients with acute appendicitis would have been discharged home. Sensitivity and specificity of the scoring system used in this study was 87% and 86%, respectively.

Conclusion: The clinical scoring system proposed in this study could be of help in early clinical diagnosis of appendicitis to reduce the rate of unnecessary emergency surgery.

MeSH terms

  • Adolescent
  • Algorithms*
  • Appendicitis / diagnosis*
  • Appendicitis / surgery*
  • Child
  • Child, Preschool
  • Diagnostic Errors / prevention & control
  • Diagnostic Errors / statistics & numerical data
  • Emergencies
  • Female
  • Humans
  • Male
  • Retrospective Studies
  • Sensitivity and Specificity