Demographic Profile and Diagnostic Accuracy of the Pediatric Appendicitis Score in Children: A Retrospective Observational Study in A Tertiary Pediatric Intensive Care Unit
), Dedy Maks(2), Andre Andre(3), Atsushi Kawaguchi(4),
(1) Department of Pediatrics, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia Department of Pediatric, Pediatric Intensive Care Unit, Murni Teguh Memorial Hospital, Medan, North Sumatera, Indonesia
(2) Department of Pediatric Surgery, Murni Teguh Memorial Hospital, Medan, North Sumatera, Indonesia
(3) Faculty of Medicine, Universitas Sumatera Utara
(4) Division of Pediatric Critical Care, Department of Pediatrics, St Marianna University School of Medicine, Kawasaki City, Kanagawa, Japan
Corresponding Author
Abstract
Background: Acute appendicitis is a frequent cause of emergency surgery in children, but diagnosis can be challenging due to nonspecific clinical presentations, particularly in younger age groups. Therefore, this study aimed to describe the demographic characteristics of pediatric patients with suspected appendicitis, evaluate the diagnostic utility of the Pediatric Appendicitis Score (PAS), and the duration of postoperative care in the pediatric intensive care unit (PICU).
Methods: This retrospective cross-sectional observational study included 15 pediatric patients with an acute abdomen who underwent exploratory laparotomy. PAS was applied, with histopathology as the reference standard, and postoperative PICU admission was performed for all patients. The variables collected were demographic data, PAS, histopathology results, and PICU length of stay. Diagnostic performance was also evaluated using sensitivity, specificity, predictive values, diagnostic accuracy, and area under the curve (AUC).
Results: The results showed that histopathologically confirmed appendicitis was more common in older children and was associated with a higher mean. Using a cutoff value ≥6, PAS showed a sensitivity of 55.6% and specificity of 83.3%, while receiver operating characteristic analysis obtained moderate discriminative ability (AUC 0.704). Postoperative PICU length of stay tended to be shorter in confirmed cases, without statistical significance (p = 0.475).
Conclusion: Pediatric appendicitis in the tertiary center predominantly affected children aged 5–18 years. The PAS showed moderate diagnostic accuracy, with good specificity but limited sensitivity. Although confirmed cases also tended to have shorter PICU stays, further studies comprising larger patient populations should be carried out to confirm and strengthen these results.
Keywords
References
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DOI: 10.24871/2722026141-149
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