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

Economist outlines reforms to improve access to affordable, high quality child care

October 22, 2017
For families in the U.S., the costs of high-quality child care are exorbitant, especially for those with children under age five. A new policy proposal, "Public Investments in Child Care," by Dartmouth Associate Professor ...

Is rushing your child to the ER the right response?

October 16, 2017
If a child gets a small burn from a hot pan, starts choking or swallows medication, parents may struggle to decide whether to provide first aid at home or rush them to the hospital, suggests a new national poll.

Happier mealtimes, healthier eating for kids

October 13, 2017
(HealthDay)—Parents who struggle to get their children to follow a healthy diet may want to make dinnertime a pleasant experience, new research suggests.

Children born prematurely have greater risk of cognitive difficulties later in life

October 11, 2017
Babies born preterm have a greater risk of developing cognitive, motor and behavioural difficulties and these problems persist throughout school years, finds a new study led by Queen Mary University of London (QMUL).

Helping preemies avoid unnecessary antibiotics

October 5, 2017
(HealthDay)—Researchers say they have identified three criteria that suggest an extremely premature infant has a low risk of developing sepsis, which might allow doctors to spare these babies early exposure to antibiotics.

Got a picky eater? How 'nature and nurture' may be influencing eating behavior in young children

October 3, 2017
For most preschool-age children, picky eating is just a normal part of growing up. But for others, behaviors such as insisting on only eating their favorite food item—think chicken nuggets at every meal—or refusing to ...

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.