Evaluation of a new scoring system for early diagnosis and management of acute appendicitis in pediatric patients

Abstract

Background Acute appendicitis is a common surgical emergency among infants and children. The diagnosis of acute appendicitis in young children remains a big challenge, as most of such patients present late, with complications. However, unnecessary surgery should be avoided. Over years, many scoring systems have been introduced for helping the diagnosis of acute appendicitis such as Alvarado score, the Pediatric Appendicitis Score (PAS), and Appendicitis Inflammatory Response score. Patients and methods In the period between 3/2018 and 9/2019, 130 infants and children till the age of 16 years, with acute right iliac pain, were included in this study. These patients were evaluated using three diagnostic scores: Acute Pediatric Appendicitis Score (APAS), PAS, and Alvarado scores. Results Logistic regression analysis yielded a model comprising nine variables, all being statistically significant (P Conclusion APAS score is a significant diagnostic tool for diagnosis of acute appendicitis in pediatrics. The study also provides a solid comparison among APAS, PAS, and Alvarado scores. APAS score is the first score in well-known literature to introduce ultrasound examination as a routine investigation among the suspected children with acute appendicitis with an accuracy of ∼95.38%.