C-reactive protein value is a strong predictor of acute appendicitis in young children

Background and aims: Acute appendicitis (AA) is among the most common causes of acute abdominal pain. Diagnosis of AA is still challenging and some controversies on its management are still present among different settings and practice patterns worldwide. In July 2015, the World Society of Emergency Surgery (WSES) organized in Jerusalem the first consensus conference on the diagnosis and treatment of AA in adult patients with the intention of producing evidence-based guidelines. An updated consensus conference took place in Nijemegen in June 2019 and the guidelines have now been updated in order to provide evidence-based statements and recommendations in keeping with varying clinical practice: use of clinical scores and imaging in diagnosing AA, indications and timing for surgery, use of nonoperative management and antibiotics, laparoscopy and surgical techniques, intra-operative scoring, and perioperative antibiotic therapy.

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“…Zouari et al highlighted the value of CRP ≥ 10 mg/L as a strong predictor of AA in children < 6 years old [57].…”

Section: Q14: What Is the Role Of Serum Biomarkers In Evaluating Pementioning

confidence: 99%

Diagnosis and treatment of acute appendicitis: 2020 update of the WSES Jerusalem guidelines

et al. 2020

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“…[15][16][17][18][19] Zouari et al estudiaron a 102 niños consecutivos que se sometieron a apendicectomía y compararon el grupo con apendicitis aguda con el grupo de exploración negativa. 20 Informaron que un nivel de proteína C reactiva ≥ 10 mg/L al ingreso y una leucocitosis ≥ 16 100/mL eran factores predictivos de apendicitis aguda pediátrica. En su estudio, Çelik et al informaron valores de corte de 10.4 y 284 y ABC de 0.71 y 0.64, respectivamente para INL y IPL en la comparación de apendicitis aguda no complicada y complicada.…”

Section: Discussionunclassified

“…4 Existen numerosos estudios que investigan el valor de corte, la sensibilidad y la especificidad del recuento leucocitario, neutrófilos, proteína C reactiva, INL, IPL y ILM en la apendicitis pediátrica. [20][21][22] Estos valores definidos difieren en casi todos ellos. Como razón principal se argumenta que los valores de corte también son diferentes debido a las diferencias poblacionales.…”

Section: Discussionunclassified

Nuevo sistema de calificación diagnóstica para apendicitis pediátrica basado en parámetros hematológicos ajustados por edad y sexo

AydoÓdu¹,

AzizoÓlu²,

Arslan³

et al. 2023

GMM

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Antecedentes: El diagnóstico de apendicitis aguda representa un reto en pacientes pediátricos. Objetivo: Establecer la importancia del índice neutrófilos-linfocitos (INL), índice plaquetas-linfocitos (IPL) y otros parámetros hematológicos ajustados por edad y sexo en la predicción de apendicitis aguda, así como describir un nuevo sistema de calificación. Material y métodos: Se analizaron retrospectivamente expedientes clínicos de 946 niños hospitalizados por apendicitis aguda. Se desarrolló un sistema de calificación basado en INL, IPL, ILM y proteína C reactiva (PCR) ajustados por edad y sexo. Resultados: Los pacientes se dividieron en grupo I de exploración negativa y grupo II de apendicitis aguda; las medias de edad correspondientes fueron 12.20 ± 2.31 y 11.56 ± 3.11. El recuento leucocitario, porcentaje de neutrófilos, INL, IPL, ILM y PCR fueron superiores en el grupo II. La calificación osciló entre 0 y 8 puntos; se determinó que 4.5 fue el mejor punto de corte para apendicitis aguda con mayor área bajo la curva (0.96), sensibilidad (94 %), especificidad (86 %), valor predictivo positivo (97.5 %), valor predictivo negativo (65 %), precisión (92.6 %) y tasa de clasificación errónea (7.4 %). Conclusión: El sistema de calificación que se propone, calculado por edad y sexo de los pacientes, se puede utilizar para evitar cirugías innecesarias.

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“…Zouari et al studied 102 consecutive children who underwent appendectomy and compared the AA group with the negative exploration group [20]. They reported that a CRP level of ≥ 10 mg/L on admission and leukocytosis of ≥ 16,100/mL were predictive factors for pediatric AA.…”

Section: Discussionmentioning

confidence: 99%

“…There are a lot of studies that investigate the cut-off value, sensitivity, and speci city of WBC, NEU, CRP, NLR, PLR, and LMR in pediatric appendicitis [20,21,22]. These de ned values differ, in almost all of them.…”

Section: Discussionmentioning

confidence: 99%

A Novel Diagnostic Scoring System for Pediatric Appendicitis Based on Age and Sex-Adjusted Hematological Parameters

Aydogdu

Azizoğlu

Arslan

et al. 2022

Preprint

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Objective Our aim is to establish the importance of age and sex-adjusted NLR, PLR, and other hematological parameters in the prediction of acute appendicitis and describe a novel scoring system. Methods The consecutive medical records of 946 pediatric patients (between 5–18) hospitalized with a diagnosis of acute appendicitis at our high-volume university hospital between January 2018 and December 2021 were retrospectively collected for analysis. The patients were divided based on perioperative findings into the negative exploration group (Group I) and the acute appendicitis group (Group II). This study developed a new scoring system based on “age and sex-adjusted” NLR, PLR, LMR, and CRP parameters. Results The mean age of Group I and II were 12.20 ± 2,31, and 11,56 ± 3,11, respectively. The white blood cell count (WBC) (p < .001), neutrophil percentage (p < .001), NLR (p < .001), PLR (p = .001), LMR (P < 0,001), and CRP (p < 0,001) were higher in the Group II compared with the Group I. The score was calculated between 0–8 points. 4.5 and above was determined as the best cut-off value for acute appendicitis with higher AUC (0,96), sensitivity (94%), specificity (86%), PPV (97,5%), NPV (65%), Accuracy (92,6%), and Misclassification Rate (7,4%). Conclusion Present scoring system calculated pertaining to patients' age and gender can be used to avoid unnecessary surgery.

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C-reactive protein value is a strong predictor of acute appendicitis in young children

Cited by 10 publications

References 3 publications

Diagnosis and treatment of acute appendicitis: 2020 update of the WSES Jerusalem guidelines

Diagnosis and treatment of acute appendicitis: 2020 update of the WSES Jerusalem guidelines

Nuevo sistema de calificación diagnóstica para apendicitis pediátrica basado en parámetros hematológicos ajustados por edad y sexo

A Novel Diagnostic Scoring System for Pediatric Appendicitis Based on Age and Sex-Adjusted Hematological Parameters

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