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      Pediatric appendicitis score.

      Journal of Pediatric Surgery

      Abdominal Pain, classification, Acute Disease, Adolescent, Appendiceal Neoplasms, etiology, pathology, surgery, Appendicitis, diagnosis, Child, Child, Preschool, Diagnosis, Differential, Female, Gastrointestinal Diseases, Humans, Logistic Models, Male, Meckel Diverticulum, Ovarian Cysts, Pancreatitis, Predictive Value of Tests, Prospective Studies, Respiratory Tract Infections, Rupture, Spontaneous, Sensitivity and Specificity

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          Morbidity in children treated with appendicitis results either from late diagnosis or negative appendectomy. A Prospective analysis of efficacy of Pediatric Appendicitis Score for early diagnosis of appendicitis in children was conducted. In the last 5 years, 1,170 children aged 4 to 15 years with abdominal pain suggestive of acute appendicitis were evaluated prospectively. Group 1 (734) were patients with appendicitis and group 2 (436) nonappendicitis. Multiple linear logistic regression analysis of all clinical and investigative parameters was performed for a model comprising 8 variables to form a diagnostic score. Logistic regression analysis yielded a model comprising 8 variables, all statistically significant, P <.001. These variables in order of their diagnostic index were (1) cough/percussion/hopping tenderness in the right lower quadrant of the abdomen (0.96), (2) anorexia (0.88), (3) pyrexia (0.87), (4) nausea/emesis (0.86), (5) tenderness over the right iliac fossa (0.84), (6) leukocytosis (0.81), (7) polymorphonuclear neutrophilia (0.80) and (8) migration of pain (0.80). Each of these variables was assigned a score of 1, except for physical signs (1 and 5), which were scored 2 to obtain a total of 10. The Pediatric Appendicitis Score had a sensitivity of 1, specificity of 0.92, positive predictive value of 0.96, and negative predictive value of 0.99. Pediatric appendicitis score is a simple, relatively accurate diagnostic tool for accessing an acute abdomen and diagnosing appendicitis in children. Copyright 2002, Elsevier Science (USA). All rights reserved.

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