Evaluation of Alvarado and Pediatric Appendicitis Scoring Systems in Diagnosis of Appendicitis in Children | ||||
| International Journal of Medical Arts | ||||
| Articles in Press, Accepted Manuscript, Available Online from 22 May 2025 | ||||
| Document Type: Original Article | ||||
| DOI: 10.21608/ijma.2025.325285.2048 | ||||
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| Authors | ||||
Abdelrhman Nemr Ramadan Abouzaid  1; Abdo Abdo Arnous2; Sayed Elhady3; Salah Ayoub Soliman4
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| 1Department of General Surgery, Itayalbaroud General Hospital, Ministry of Health, Egypt | ||||
| 2Department of Pediatric Surgery, Damietta Faculty of Medicine, Al-Azhar University, Egypt. | ||||
| 3Department of Pediatric Surgery, Dameitta Faculty of Medicine, Al-Azhar University, Egypt | ||||
| 4Department of General Surgery, Damietta Faculty of Medicine, Al-Azhar University, Egypt | ||||
| Abstract | ||||
| Background: Acute appendicitis (AA) in pediatrics is associated with high morbidity or even mortality due to late diagnosis. Thus early diagnosis is crucial. Many indicators and scoring systems were introduced aiming to early diagnose the AA. However, there is no consensus yet on the standard score. The aim of the work: The current work aimed to compare the Alvarado and Pediatric Appendicitis Score (PAS) scoring systems in the setting the diagnosis of AA in children Methods: This study included 80 patients. All patients were subjected to standard clinical assessment. In addition, the assessment was completed by the laboratory and radiological investigations. These included complete blood count (with stress on leucocytes and neutrophils), ESR and C-reactive protein. Finally ultrasound and/or computed tomography were performed. Accuracy of the Alvarado and PAS scoring systems in prediction of appendicitis in children, as determined by surgical findings and/or follow-up imaging was the primary outcome. Results: Alvarado score at cut-off ≥ 7 had 81.69% sensitivity, 88.89% specificity, 98.3% PPV and 38.1% NPV. In addition, the score can significantly predict acute appendicitis (P value <0.001 and AUC = 0.914). In addition, at cut-off ≥ 5 with 79.1% sensitivity, 85.7% specificity, 84.7% PPV and 30.4% NPV (P value <0.001 and AUC = 0.900). In addition, PAS can significantly predict acute appendicitis (P value <0.001 and AUC = 0.933) at cut-off >5 with 90.14% sensitivity, 88.89% specificity, 98.5% PPV and 53.3% NPV. Alvarado score was insignificantly different than PAS in prediction of acute appendicitis (P value =0.741 and difference between areas = 0.019). The histopathological findings were positive in 74 (92.5%) patients. In addition, 6 cases (7.5%) were submitted to unnecessary appendectomies. Conclusion: Both scores can predict the acute appendicitis with accepted accuracy. Alvarado score was insignificantly different than PAS in prediction of acute appendicitis. | ||||
| Keywords | ||||
| Appendicitis; Child; Diagnosis | ||||
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