Accuracy of Clinical Appendicitis Score in Children with Suspected Acute Appendicitis in Trang Hospital
Keywords:
Acute appendicitis, children, RIPASA, Lintula, Alvarado, Pediatric Alvarado scoreAbstract
Background: Acute appendicitis is a common acute abdomen in children. Patients with appendicitis require urgent treatment. Early diagnosis can help reduce the incidence of disability or death and decrease the rate of negative appendectomy, particularly in children where early-stage diagnosis is challenging.
Objective: This study aims to examine the accuracy of the Lintula score, RIPASA score, Alvarado score, and Pediatric Appendicitis score in diagnosing acute appendicitis in children.
Materials and Methods: This diagnostic test study collected retrospective data on patients aged 2-15 years admitted with abdominal pain and suspected Acute appendicitis at Trang Hospital from July 2020 to July 2023. The study included 418 cases, comparing the accuracy of each scoring system. Using AUROC for accuracy assessment, STATA was employed to analyze each score system's accuracy.
Results: 252 patients were diagnosed with acute appendicitis by biopsy out of 286 total appendectomies (88.11%). Sensitivity of RIPASA≥7.5 points, Lintula≥21 points, Alvarado≥ 7 points, PAS≥ 7 points equal 95.63%, 41.27%, 81.75%, and 75.79%, respectively. Specificity equals 40.61%, 93.33%, 64.85%, and 77.58%, respectively. Comparison between areas under the ROC curve (AUC) equals 0.86, 0.85, 0.81, and 0.84, respectively. When looking for cutoff values for the diagnosis of acute appendicitis in children that are appropriate for the population in this research, the sensitivity and specificity of RIPASA≥9.75 points, Lintula≥13.5 points were increased, while Alvarado≥ 6.5. Score, PAS≥ 6.5 points, which is considered not different. The area under the ROC curve (AUC) was 0.80 for RIPASA, which still had the highest accuracy of the four systems when finding new cutoff points.
Conclusions: The RIPASA scoring system demonstrates the highest accuracy rate for diagnosing Acute appendicitis in children among all available scoring systems. It can be utilized as an alternative scoring system for pediatric appendicitis patients' initial diagnosis and treatment planning.
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เนื้อหาและข้อมูลในบทความที่ลงตีพิมพ์ในมหาราชนครศรีธรรมราชเวชสาร ถือเป็นข้อคิดเห็นและความรับผิดชอบของผู้เขียนบทความโดยตรงซึ่งกองบรรณาธิการวารสาร ไม่จำเป็นต้องเห็นด้วย หรือร่วมรับผิดชอบใด ๆ
บทความ ข้อมูล เนื้อหา รูปภาพ ฯลฯ ที่ได้รับการตีพิมพ์ในมหาราชนครศรีธรรมราชเวชสาร ถือเป็นลิขสิทธิ์ของมหาราชนครศรีธรรมราชเวชสาร หากบุคคลหรือหน่วยงานใดต้องการนำทั้งหมดหรือส่วนหนึ่งส่วนใดไปเผยแพร่ต่อหรือเพื่อกระทำการใด จะต้องได้รับอนุญาตเป็นลายลักษณ์อักษรจากวารสารมหาราชนครศรีธรรมราชเวชสาร ก่อนเท่านั้น
