Validación de la Puntuación de Apendicitis Pediátrica frente a la puntuación de Alvarado, para el diagnóstico de apendicitis

Abstract

Background. Appendicitis is the most common surgical pathology in childhood. A fast and accurate method is required for the child to avoid excess laboratory test results and unnecessary appendectomies. Diagnostic scores are systematic processes to order the semiology and laboratory for the right diagnosis. Objective. Determine sensitivity, specificity and likelihood ratio of PAS and Alvarado scores for diagnosis of acute appendicitis in children 4-15 years old treated in pediatric emergency department Vicente Corral Hospital. Material and methods. With a design validation, 161 children with clinical suspicion of acute appendicitis to which the two scores before being applied appendectomy were included. The proportion of agreements between the tests regarding the histology was compared. Results. Sample had a predominance of males. Median age 12 years, weight 37.5 ± 12.2 kg, 138.5 ± 15.4 cm height and 42% of malnourished. PAS sensitivity was higher (97.1 vs 79.8) but the lowest specificity (50 vs. 59). The NPV of PAS was higher (73.1 vs 31.7). Agreements between histology and tests for PAS study were higher (90.7% vs 74.5%). There were more false negatives with Alvarado scores (P <0.001). Conclusion. PAS is a diagnostic tool easy to use and reliable to decide surgery suspected acute appendicitis in children. Until there is conclusive evidence of the use of both ratings it should be considered a good clinical practice