Ultrason, Alvarado Skoru ve C-Reaktif Proteinin Pediatrik Appendectomilerdeki Prediktör Değeri

Abstract

Purpose: This retrospective study aimed to investigate the combined accuracy of appendix diameter, C reactive protein, and Alvarado score in classifying the patients with negative appendectomy and acute appendicitis. Methods: This descriptive observational cohort study research was conducted at the Emergency Department of a Training and Research Hospital between November 2017 and April 2019. We included the data of appendicitis cases aged under 18 years in this retrospective study and gathered data on patients` demographics, preoperative laboratory values, signs, symptoms, and final pathological diagnosis, retrospectively. Then, cases were divided into acute appendicitis or negative appendectomy groups according to formal pathology reports. Results: The final study population consisted of 60 patients; the negative appendectomy rate was 25%. The multivariate model`s diagnostic accuracy involving CRP, Alvarado score, and appendix diameter was 93.3%, with sensitivity and specificity of 93.3% for identifying acute appendicitis (+LR: 14 and -LR: 0.07). Applying the model could had saved 93.3% of negative appendectomy cases (25% to 1.7%) from unnecessary surgery in our cohort. Conclusion: In conclusion, CRP, Alvarado score, or appendix diameter should not be used individually to diagnose AA in children. However, combining these variables can increase the accuracy of acute appendicitis diagnosis and may provide a significant reduction in negative appendectomy rates.