Ramon R Gorter1, Anne Loes van den Boom2, Hugo A Heij3, C M Frank Kneepkens4, Caroline C Hulsker3, Mark Tenhagen5, Imro Dawson2, Johanna H van der Lee6. 1. Department of Paediatric Surgery, Paediatric Surgical Centre of Amsterdam, Emma Children's Hospital AMC & VU University Medical Centre, Amsterdam, The Netherlands; Department of Surgery, Red Cross Hospital, Beverwijk, The Netherlands. Electronic address: rr.gorter@vumc.nl. 2. Department of Surgery, IJsselland Hospital, Capelle aan Den IJssel, The Netherlands. 3. Department of Paediatric Surgery, Paediatric Surgical Centre of Amsterdam, Emma Children's Hospital AMC & VU University Medical Centre, Amsterdam, The Netherlands. 4. Department of Paediatric Gastroenterology, VU University Medical Centre, Amsterdam, The Netherlands. 5. Department of Surgery, Red Cross Hospital, Beverwijk, The Netherlands. 6. Division Woman and Child, Academic Medical Centre, Amsterdam, The Netherlands.
Abstract
BACKGROUND: It appears that two forms of appendicitis exist. Preoperative distinction between the two is essential to optimize treatment outcome. This study aimed to develop a scoring system to accurately determine the severity of appendicitis in children. MATERIALS AND METHODS: Historical cohort study of pediatric patients (aged 0-17 y old) with appendicitis treated between January 2010 and December 2012. Division into simple, complex appendicitis, or another condition based on preset criteria. Multiple logistic regression analysis was used to build the prediction model with subsequent validation. RESULTS: There were 64 patients with simple and 66 with complex appendicitis. Five variables explained 64% of the variation. Independent validation of the derived prediction model in a second cohort (55 simple and 10 complex appendicitis patients) demonstrated 90% sensitivity (54-99), 91% specificity (79-97), a positive predictive value of 64% (36-86), and an negative predictive value of 98% (88-100). The likelihood ratio+ was 10 (4.19-23.42), and likelihood ratio- was 0.11 (0.02-0.71). Diagnostic accuracy was 91% (84-98). CONCLUSIONS: Our scoring system consisting of five variables can be used to exclude complex appendicitis in clinical practice if the score is <4.
BACKGROUND: It appears that two forms of appendicitis exist. Preoperative distinction between the two is essential to optimize treatment outcome. This study aimed to develop a scoring system to accurately determine the severity of appendicitis in children. MATERIALS AND METHODS: Historical cohort study of pediatric patients (aged 0-17 y old) with appendicitis treated between January 2010 and December 2012. Division into simple, complex appendicitis, or another condition based on preset criteria. Multiple logistic regression analysis was used to build the prediction model with subsequent validation. RESULTS: There were 64 patients with simple and 66 with complex appendicitis. Five variables explained 64% of the variation. Independent validation of the derived prediction model in a second cohort (55 simple and 10 complex appendicitispatients) demonstrated 90% sensitivity (54-99), 91% specificity (79-97), a positive predictive value of 64% (36-86), and an negative predictive value of 98% (88-100). The likelihood ratio+ was 10 (4.19-23.42), and likelihood ratio- was 0.11 (0.02-0.71). Diagnostic accuracy was 91% (84-98). CONCLUSIONS: Our scoring system consisting of five variables can be used to exclude complex appendicitis in clinical practice if the score is <4.
Authors: Louis J X Giesen; Anne Loes van den Boom; Charles C van Rossem; P T den Hoed; Bas P L Wijnhoven Journal: Dig Surg Date: 2016-09-16 Impact factor: 2.588
Authors: Sarah-May M L The; Tim G J de Meij; Andries E Budding; Roel Bakx; Johanna H van der Lee; Linda Poort; Huib A Cense; Hugo A Heij; L W Ernst van Heurn; Ramon R Gorter Journal: Eur J Pediatr Date: 2022-10-04 Impact factor: 3.860
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Authors: Paul van Amstel; Roel Bakx; Johanna H van der Lee; Marijke C van der Weide; Rik van Eekelen; Joep P M Derikx; Ernest L W van Heurn; Ramon R Gorter Journal: BMJ Open Date: 2022-02-17 Impact factor: 2.692