Annals of Emergency Medicine
Volume 49, Issue 6 , Pages 778-784.e1 , June 2007

Evaluating Appendicitis Scoring Systems Using a Prospective Pediatric Cohort

Presented at the Pediatric Academic Societies meeting, May 2006, San Francisco, CA.

  • Carisa Schneider, MD

      Affiliations

    • Department of Medicine, Children’s Hospital Boston, Harvard Medical School, Boston, MA
    • Corresponding Author InformationAddress for correspondence: Carisa Schneider, MD. Department of Medicine, Children’s Hospital Boston, 300 Longwood Ave, Boston, MA 02115. Tel (617) 355-6000
    • ,
  • Anupam Kharbanda, MD

      Affiliations

    • Division of Pediatric Emergency Medicine, Morgan Stanley Children’s Hospital of New York, Columbia University, New York, NY.
    • ,
  • Richard Bachur, MD

      Affiliations

    • Department of Medicine, Children’s Hospital Boston, Harvard Medical School, Boston, MA
    • Division of Emergency Medicine, Children’s Hospital Boston, Harvard Medical School, Boston, MA

Received 24 May 2006 ,Revised 19 December 2006 ,Accepted 20 December 2006.

References 

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  2. Kharbanda AB, Taylor GA, Fishman SJ, et al. A clinical decision rule to identify children at low risk for appendicitis. Pediatrics. 2005;116:709–716
  3. Kwok MY, Kim MK, Gorelick MH. Evidence-based approach to the diagnosis of appendicitis in children. Pediatr Emerg Care. 2004;20:690–698
  4. Mohammed AA, Daghman NA, Aboud SM, et al. The diagnostic value of C-reactive protein, white blood cell count and neutrophil percentage in childhood appendicitis. Saudi Med J. 2004;25:1212–1215
  5. Van Den Broek W, Van der Ende ED, Bijnen AB, et al. Which children could benefit from additional diagnostic tools in case of suspected appendicitis?. J Pediatr Surg. 2004;39:570–574
  6. Alvarado A. A practical score for the early diagnosis of acute appendicitis. Ann Emerg Med. 1986;15:557–564
  7. Samuel M. Pediatric appendicitis score. J Pediatr Surg. 2002;37:877–881
  8. Hsiao KH, Lin LH, Chen DF. Application of the MANTRELS scoring system in the diagnosis of acute appendicitis in children. Acta Paediatr Taiwan. 2005;46:128–131
  9. Bond GR, Tully SB, Chan LS, et al. Use of the MANTRELS score in childhood appendicitis: a prospective study of 187 children with abdominal pain. Ann Emerg Med. 1990;19:1014–1018
  10. Macklin CP, Radcliffe GS, Merei JM, et al. A prospective evaluation of the modified Alvarado score for acute appendicitis in children. Ann R Coll Surg Engl. 1997;79:203–205May
  11. Khan I, ur Rehman A. Application of Alvarado scoring system in diagnosis of acute appendicitis. J Ayub Med Coll Abbottabad. 2005;17:41–44
  12. Garcia Pena CE, Mandl KD. Selective imaging strategies for the diagnosis of appendicitis in children. Pediatrics. 2004;113:24–28
  13. Concato J, Feinstein AR, Holford TR. The risk of determining risk with multivariable models. Ann Intern Med. 1993;118:201–210
  14. Laupacis A, Sekar N, Stiell IG. Clinical prediction rules: a review and suggested modifications of methodological standards. JAMA. 1997;277:488–494
  15. York D, Smith A, Phillips JD, et al. The influence of advanced radiographic imaging on the treatment of pediatric appendicitis. J Pediatr Surg. 2005;40:1908–1911
  16. Martin AE, Vollman D, Adler B, et al. CT scans may not reduce the negative appendectomy rate in children. J Pediatr Surg. 2004;39:886–890
  17. Stephen AE, Segev DL, Ryan DP, et al. The diagnosis of acute appendicitis in a pediatric population: to CT or not to CT. J Pediatr Surg. 2003;38:367–371
  18. Doria AS, Moineddin R, Kellenberger CJ, et al. US or CT for diagnosis of appendicitis in children and adults? (a meta-analysis). Radiology. 2006;241:83–94
  19. Taylor GA. Suspected appendicitis in children: in search of the single best diagnostic test. Radiology. 2004;231:293–295
  20. Chakhunashvili L, Inasaridze A, Svanidze S, et al. Procalcitonin as the biomarker of inflammation in diagnostics of pediatric appendicular peritonitis and for the prognosis of early postoperative complications. Georgian Med News. 2005;(129):78–81
  21. Kafetzis DA, Velissariou IM, Nikolaides P, et al. Procalcitonin as a predictor of severe appendicitis in children. Eur J Clin Microbiol Infect Dis. 2005;24:484–487

 Supervising editor: David M. Jaffe, MDAuthor contributions: AK and RB conceived the study and designed the trial. AK and RB supervised the conduct of the trial and data collection. AK and RB undertook recruitment of patients and managed the data, including quality control. RB provided statistical advice on study design, RB takes responsibility for all statistical calculations in the manuscript, CS and RB analyzed the data, CD drafted the manuscript, and all authors contributed substantially to its revision. CD, AK and RB take responsibility for the paper as a whole.Funding and support: The authors report this study did not receive any outside funding or support.Publication dates: Available online March 26, 2007.Reprints not available from the authors.

PII: S0196-0644(06)02685-0

doi: 10.1016/j.annemergmed.2006.12.016

Annals of Emergency Medicine
Volume 49, Issue 6 , Pages 778-784.e1 , June 2007

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