Appendicitis predictive score for children younger than 4 years
Introduction: The clinical presentation of acute appendicitis in infants and young children is nonspecific. The diagnosis is often delayed and is accompanied by high rates of appendiceal perforation. The aim of the present study was to develop an early diagnostic scale for acute appendicitis in chil...
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| Formato: | Artículo revista |
| Lenguaje: | Español |
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Universidad Nacional Córdoba. Facultad de Ciencias Médicas. Secretaria de Ciencia y Tecnología
2023
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| Materias: | |
| Acceso en línea: | https://revistas.unc.edu.ar/index.php/med/article/view/40962 |
| Aporte de: |
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I10-R327-article-40962 |
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ojs |
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Universidad Nacional de Córdoba |
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I-10 |
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R-327 |
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Revista de la Facultad de Ciencias Médicas de Córdoba |
| language |
Español |
| format |
Artículo revista |
| topic |
appendicites appendicititis/ Diagnostic Imaging abdominal pain apendicitis Diagnóstico por imagen dolor abdominal apendicite diagnóstico por imagem ; ; valor preditive dos testes ; dor abdominal; |
| spellingShingle |
appendicites appendicititis/ Diagnostic Imaging abdominal pain apendicitis Diagnóstico por imagen dolor abdominal apendicite diagnóstico por imagem ; ; valor preditive dos testes ; dor abdominal; Rassi, Ricardo Muse, Florencia Cuestas, Eduardo Appendicitis predictive score for children younger than 4 years |
| topic_facet |
appendicites appendicititis/ Diagnostic Imaging abdominal pain apendicitis Diagnóstico por imagen dolor abdominal apendicite diagnóstico por imagem ; ; valor preditive dos testes ; dor abdominal; |
| author |
Rassi, Ricardo Muse, Florencia Cuestas, Eduardo |
| author_facet |
Rassi, Ricardo Muse, Florencia Cuestas, Eduardo |
| author_sort |
Rassi, Ricardo |
| title |
Appendicitis predictive score for children younger than 4 years |
| title_short |
Appendicitis predictive score for children younger than 4 years |
| title_full |
Appendicitis predictive score for children younger than 4 years |
| title_fullStr |
Appendicitis predictive score for children younger than 4 years |
| title_full_unstemmed |
Appendicitis predictive score for children younger than 4 years |
| title_sort |
appendicitis predictive score for children younger than 4 years |
| description |
Introduction: The clinical presentation of acute appendicitis in infants and young children is nonspecific. The diagnosis is often delayed and is accompanied by high rates of appendiceal perforation. The aim of the present study was to develop an early diagnostic scale for acute appendicitis in children less than 4 years of age.
Patients and methods: 100 children less than 4 years of age with a presumptive diagnosis of acute appendicitis were retrospectively evaluated in 4 hospitals. The case group comprised 90 patients with histopathological diagnosis of positive appendicitis (with inflammation in the appendiceal wall) while the control group comprised 10 patients with a histopathological diagnosis of negative appendicitis (without inflammation). Epidemiological, clinical, laboratory, and ultrasound variables were screened using Least Absolute Shrinkage and Selection Operator (LASSO) and logistic regression to construct a predictive risk score. Accuracy of the score was measured by the area under the receiver operating characteristic curve. Final model comprised 4 variables (Blumberg's sign, C-reactive protein, neutrophil-lymphocyte index and positive ultrasound).
Results: The scale had a high discrimination index area under the ROC curve of 0.96 (95%CI 0.88-0.99), sensitivity of 95.1% (95%CI 86.3-99.0%), specificity of 90.0% (95%CI 55.7-89.5%), positive predictive value of 98.3% (95%CI 90.0-99.7%) and negative predictive value of 75.0% (95%CI 49.4-90.2).
Conclusions: In this study, a risk score based on characteristics of children less than 4 years with abdominal pain was developed that may help predict a patient’s risk of developing acute appendicitis. |
| publisher |
Universidad Nacional Córdoba. Facultad de Ciencias Médicas. Secretaria de Ciencia y Tecnología |
| publishDate |
2023 |
| url |
https://revistas.unc.edu.ar/index.php/med/article/view/40962 |
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2024-09-03T21:04:31Z |
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2024-09-03T21:04:31Z |
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I10-R327-article-409622023-07-31T16:15:02Z Appendicitis predictive score for children younger than 4 years Escala predictiva de apendicitis para menores de 4 años Escala preditiva de apendicite para menores de 4 anos Rassi, Ricardo Muse, Florencia Cuestas, Eduardo appendicites appendicititis/ Diagnostic Imaging abdominal pain apendicitis Diagnóstico por imagen dolor abdominal apendicite diagnóstico por imagem ; ; valor preditive dos testes ; dor abdominal; Introduction: The clinical presentation of acute appendicitis in infants and young children is nonspecific. The diagnosis is often delayed and is accompanied by high rates of appendiceal perforation. The aim of the present study was to develop an early diagnostic scale for acute appendicitis in children less than 4 years of age. Patients and methods: 100 children less than 4 years of age with a presumptive diagnosis of acute appendicitis were retrospectively evaluated in 4 hospitals. The case group comprised 90 patients with histopathological diagnosis of positive appendicitis (with inflammation in the appendiceal wall) while the control group comprised 10 patients with a histopathological diagnosis of negative appendicitis (without inflammation). Epidemiological, clinical, laboratory, and ultrasound variables were screened using Least Absolute Shrinkage and Selection Operator (LASSO) and logistic regression to construct a predictive risk score. Accuracy of the score was measured by the area under the receiver operating characteristic curve. Final model comprised 4 variables (Blumberg's sign, C-reactive protein, neutrophil-lymphocyte index and positive ultrasound). Results: The scale had a high discrimination index area under the ROC curve of 0.96 (95%CI 0.88-0.99), sensitivity of 95.1% (95%CI 86.3-99.0%), specificity of 90.0% (95%CI 55.7-89.5%), positive predictive value of 98.3% (95%CI 90.0-99.7%) and negative predictive value of 75.0% (95%CI 49.4-90.2). Conclusions: In this study, a risk score based on characteristics of children less than 4 years with abdominal pain was developed that may help predict a patient’s risk of developing acute appendicitis. Introducción: La presentación clínica de la apendicitis aguda en niños pequeños es inespecífica. El diagnóstico suele demorarse y se acompaña de elevadas tasas de perforación apendicular. Objetivo: Desarrollar una escala de diagnóstico temprano de apendicitis para menores de 4 años. Pacientes y métodos: 100 menores de 4 años apendicectomizados con diagnóstico presuntivo de apendicitis aguda fueron estudiados retrospectivamente en 4 hospitales. El grupo de casos estuvo conformado por 90 pacientes con diagnóstico histopatológico de apendicitis positiva (con inflamación en la pared apendicular) mientras que el grupo de controles estuvo conformado por 10 pacientes con diagnóstico histopatológico de apendicitis negativa (sin inflamación). Las variables demográficas, clínicas, de laboratorio y ecográficas se analizaron mediante selección LASSO y regresión logística para construir una escala predictiva de riesgo de apendicitis. La precisión de la escala se midió por el área bajo la curva de características operativas del receptor. El modelo final comprendió 4 variables (signo de Blumberg, proteína C reactiva, índice neutrófilos-linfocitos y ecografía). Resultados: La escala presentó una elevada precisión 0,96 (IC95% 0,88-0,99), una sensibilidad de 95,1% (IC95 86,3-99,0%), una especificidad de 90,0% (IC95% 55,7-89,5%), un valor predictivo positivo de 98,3% (IC95% 90,0-99,7%) y un valor predictivo negativo de 75,0% (IC95% 49,4-90,2). Conclusiones: En este estudio se desarrolló una escala predictiva basada en las características de los niños menores de 4 años con dolor abdominal agudo que puede ayudar a predecir el riesgo de apendicitis aguda en este grupo etario. Introdução: A apresentação clínica da apendicite aguda em crianças pequenas é inespecífica. O diagnóstico é muitas vezes tardio e é acompanhado por altas taxas de perfuração do apêndice. Objetivo: Desenvolver uma escala para diagnóstico precoce de apendicite para crianças menores de 4 anos. Pacientes e métodos: 100 crianças menores de 4 anos submetidas a apendicectomia com diagnóstico presuntivo de apendicite aguda foram estudadas retrospectivamente em 4 hospitais. O grupo caso consistiu de 90 pacientes com diagnóstico histopatológico de apendicite positivo (com inflamação na parede apendicular) enquanto o grupo controle consistiu de 10 pacientes com diagnóstico histopatológico de apendicite negativo (sem inflamação). Variáveis demográficas, clínicas, laboratoriais e ultrassonográficas foram analisadas por seleção LASSO e regressão logística para construir uma escala preditiva de risco para apendicite. A precisão da escala foi medida pela área sob a curva característica de operação do receptor. O modelo final compreendeu 4 variáveis (sinal de Blumberg, proteína C-reativa, relação neutrófilo-linfócito e ultrassonografia). Resultados: A escala apresentou alta precisão de 0,96 (IC95% 0,88-0,99), sensibilidade de 95,1% (IC95 86,3-99,0%), especificidade de 90,0% (IC 95% 55,7-89,5%), um preditivo positivo valor preditivo negativo de 98,3% (IC95% 90,0-99,7%) e valor preditivo negativo de 75,0% (IC95% 49,4-90,2). Conclusões: Neste estudo, foi desenvolvida uma escala preditiva baseada nas características de crianças menores de 4 anos com dor abdominal aguda que pode ajudar a prever o risco de apendicite aguda nessa faixa etária. Universidad Nacional Córdoba. Facultad de Ciencias Médicas. Secretaria de Ciencia y Tecnología 2023-06-30 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion Text Texto Texto application/pdf text/html https://revistas.unc.edu.ar/index.php/med/article/view/40962 10.31053/1853.0605.v80.n2.40962 Revista de la Facultad de Ciencias Médicas de Córdoba.; Vol. 80 No. 2 (2023); 119-125 Revista de la Facultad de Ciencias Médicas de Córdoba; Vol. 80 Núm. 2 (2023); 119-125 Revista da Faculdade de Ciências Médicas de Córdoba; v. 80 n. 2 (2023); 119-125 1853-0605 0014-6722 10.31053/1853.0605.v80.n2 spa https://revistas.unc.edu.ar/index.php/med/article/view/40962/41757 https://revistas.unc.edu.ar/index.php/med/article/view/40962/42187 Derechos de autor 2023 Universidad Nacional de Córdoba http://creativecommons.org/licenses/by-nc/4.0 |