Demographic Profile and Diagnostic Accuracy of the Pediatric Appendicitis Score in Children: A Retrospective Observational Study in A Tertiary Pediatric Intensive Care Unit

Authors

  • Ririe Fachrina Malisie 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
  • Dedy Maks Department of Pediatric Surgery, Murni Teguh Memorial Hospital, Medan, North Sumatera, Indonesia
  • Andre Andre Faculty of Medicine, Universitas Sumatera Utara https://orcid.org/0009-0009-0657-2353
  • Atsushi Kawaguchi Division of Pediatric Critical Care, Department of Pediatrics, St Marianna University School of Medicine, Kawasaki City, Kanagawa, Japan

DOI:

https://doi.org/10.24871/2722026141-149

Keywords:

Appendicitis, Child, Diagnostic Accuracy, Pediatric Appendicitis Score, Pediatric Intensive Care Unit

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.

Author Biographies

Ririe Fachrina Malisie, 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

Dr. Ririe is a pediatric intensivist currently practicing in the Pediatric Intensive Care Unit at a tertiary referral hospital in Indonesia. Her clinical and research interests focus on critical care medicine, pediatric sepsis, acute respiratory failure, and diagnostic tools in emergency pediatric settings. She has been actively involved in clinical research, academic presentation, and multidisciplinary collaboration to improve outcomes in critically ill children.

Dedy Maks, Department of Pediatric Surgery, Murni Teguh Memorial Hospital, Medan, North Sumatera, Indonesia

Dr. Dedy Maks is a pediatric surgeon practicing at a tertiary care center in Indonesia. His clinical expertise includes pediatric abdominal emergencies, minimally invasive pediatric surgery, and perioperative care in critically ill children. He is actively involved in clinical service, research, and surgical education, with a particular interest in improving diagnostic pathways and surgical outcomes in pediatric appendicitis and other acute surgical conditions.

Andre Andre, Faculty of Medicine, Universitas Sumatera Utara

General practitioner, graduate of the Faculty of Medicine, Universitas Sumatera Utara, with interests in clinical medicine, public health, and medical research.

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Published

2026-08-31

How to Cite

Malisie, R. F., Maks, D., Andre, A., & Kawaguchi, A. (2026). Demographic Profile and Diagnostic Accuracy of the Pediatric Appendicitis Score in Children: A Retrospective Observational Study in A Tertiary Pediatric Intensive Care Unit. The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy, 27(2), 141–149. https://doi.org/10.24871/2722026141-149

Issue

Vol. 27 No. 2 (2026): VOLUME 27, NUMBER 2, August, 2026

Section

Original Articles

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