Combination protocol accurately diagnoses appendicitis in kids

January 5, 2014
Combination protocol accurately diagnoses appendicitis in kids
A clinical pathway combining the Samuel's pediatric appendicitis score and selective use of ultrasonography has high sensitivity and specificity for diagnosing appendicitis in children, according to a study published online Dec. 30 in Pediatrics.

(HealthDay)—A clinical pathway combining the Samuel's pediatric appendicitis score (PAS) and selective use of ultrasonography (US) has high sensitivity and specificity for diagnosing appendicitis in children, according to a study published online Dec. 30 in Pediatrics.

Ashley Saucier, M.D., from the University of Tennessee Health Science Center in Memphis, and colleagues conducted a prospective observational cohort study involving 196 patients to assess the of a for suspected appendicitis. Based on initial assessment, patients were determined to be at low (PAS 1 to 3), intermediate (PAS 4 to 7), or high (PAS 8 to 10) risk for appendicitis. Patients at low risk were discharged with telephone follow-up; those at intermediate risk underwent US evaluation; and those at high risk received immediate surgical consultation.

The researchers found that 65 patients (33.2 percent) had appendicitis. A total of 65.3 percent of patients underwent US and 37.5 percent were positive. Surgical consultants requested an abdominal computed tomography scan for 6.6 percent of patients. Three of 68 patients had a negative appendectomy (4.4 percent). Based on follow-up of 96.9 percent of patients, overall diagnostic accuracy of the pathway was 94 percent, with sensitivity and specificity of 92.3 and 94.7 percent, respectively. The positive likelihood ratio was 17.3 and the negative likelihood ratio was 0.08.

"Our study suggests that a clinical pathway combining PAS and US for use in children with suspected presenting to our demonstrates higher sensitivity and specificity than using the PAS alone," the authors write.

Explore further: Support for ultrasound first in pediatric appendicitis diagnosis

More information: Abstract
Full Text

Related Stories

Support for ultrasound first in pediatric appendicitis diagnosis

December 14, 2013
(HealthDay)—During the transition to an ultrasound-first paradigm for imaging acute appendicitis in pediatric patients, there does not seem to be any increase in complicated appendicitis diagnoses or a longer median hospital ...

Speed bumps could be a new way to help diagnose appendicitis

December 17, 2012
The presence of pain when travelling over speed bumps is associated with an increased likelihood of acute appendicitis, among patients coming into hospital with abdominal pain, finds a study in the BMJ Christmas issue and ...

Low-dose CT noninferior for diagnosing appendicitis

April 26, 2012
(HealthDay) -- For young adults with suspected appendicitis, low-dose computed tomography (CT) is noninferior to standard-dose CT with respect to negative appendectomy rates, according to a study published in the April 26 ...

Ultrasound diagnoses appendicitis without X-rays

December 27, 2012
Children suspected of having appendicitis are more likely to receive CT scans, which involve radiation, if they are evaluated at a general hospital, a new study by Washington University School of Medicine in St. Louis has ...

Recommended for you

Study shows probiotics can prevent sepsis in infants

August 17, 2017
A research team at the University of Nebraska Medical Center College of Public Health has determined that a special mixture of good bacteria in the body reduced the incidence of sepsis in infants in India by 40 percent at ...

Children who sleep an hour less at higher risk of type 2 diabetes, says study

August 15, 2017
A study has found that children who slept on average one hour less a night had higher risk factors for type 2 diabetes, including higher levels of blood glucose and insulin resistance.

Low blood sugars in newborns linked to later difficulties

August 8, 2017
A newborn condition affecting one in six babies has been linked to impairment in some high-level brain functions that shows up by age 4.5 years.

Can breast milk feed a love of vegetables?

August 4, 2017
(HealthDay)—Want your preschooler to eat veggies without a fuss? Try eating veggies while you're breast-feeding.

Small drop in measles vaccinations would have outsized effect, study estimates

July 24, 2017
Small reductions in childhood measles vaccinations in the United States would produce disproportionately large increases in the number of measles cases and in related public health costs, according to a new study by researchers ...

At the cellular level, a child's loss of a father is associated with increased stress

July 18, 2017
The absence of a father—due to incarceration, death, separation or divorce—has adverse physical and behavioral consequences for a growing child. But little is known about the biological processes that underlie this link ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.