Validity of Appendicitis Inflammatory Response Score in Distinguishing Perforated from Non-Perforated Appendicitis in Children
Abstract
1. Introduction
2. Materials and Methods
2.1. Patients
2.2. Study Protocol
2.3. Clinical Diagnosis and Indication for Surgery
2.4. Operative Technique
2.5. Outcome Measures
2.6. Follow-Up
2.7. Statistical Analysis
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Predictive Factor | ||
---|---|---|
Vomiting | 1 | |
Pain in the RIF of abdomen | 1 | |
Rebound tenderness/abdominal guarding | Light | 1 |
Medium | 2 | |
Strong | 3 | |
Body temperature ≥38.5 °C | 1 | |
Polymorphonuclear leukocytes | <70% | 0 |
70–84% | 1 | |
≥85% | 2 | |
CRP level | <10 mg/L | 0 |
10–49 mg/L | 1 | |
≥50 mg/L | 2 | |
WBC count | <10 × 109/L | 0 |
10–14.9 × 109/L | 1 | |
≥15 × 109/L | 2 |
Group I | Group II | p | |
---|---|---|---|
Perforated Appendicitis (n = 38) | Non-Perforated Appendicitis (n = 146) | ||
Demographic characteristics of patients | |||
Age (years) median (IQR) | 10 (8, 12.5) | 11 (9, 14) | 0.098 ‡ |
Gender n (%) Male Female | 0.355 † | ||
27 (71) | 92 (63) | ||
11 (29) | 54 (37) | ||
Weight (kg) mean ± SD | 0.342 * | ||
44.2 ± 19.1 | 47.4 ± 17.4 | ||
Height (cm) mean ± SD | 0.230 * | ||
150.1 ± 22.3 | 154.9 ± 19.7 | ||
BMI (kg/m2) median (IQR) | 18.9 (16.7, 22.3) | 19.1 (16.2, 24.5) | 0.679 ‡ |
Clinical data of patients | |||
Duration of symptoms (h) median (IQR) | 50 (36, 84) | 24 (16, 30) | <0.001 ‡ |
Body temperature (°C) mean ± SD | <0.001 * | ||
38.2 ± 0.8 | 37.4 ± 0.6 | ||
Vomiting n (%) | 28 (73.7) | 83 (56.8) | 0.059 † |
Pain in RIF n (%) | 38 (100) | 146 (100) | >0.999 † |
Rebound tenderness n (%) | 38 (100) | 146 (100) | >0.999 † |
Laboratory data of patients | |||
WBC count (×109/L) mean ± SD | <0.001 * | ||
17.5 ± 5.3 | 14.2 ± 4.1 | ||
CRP level (mg/L) mean ± SD | <0.001 * | ||
111.6 ± 81.3 | 33.6 ± 40.2 | ||
Polymorphonuclear leukocytes (%) mean ± SD | 0.003 * | ||
83.9 ± 6.9 | 80.1 ± 7.0 |
Group I | Group II | p | |
---|---|---|---|
Perforated Appendicitis (n = 38) | Non-Perforated Appendicitis (n = 146) | ||
Surgical approach, n (%) | |||
Open appendectomy | 14 (36.8) | 24 (16.4) | |
Laparoscopic appendectomy | 24 (63.2) | 122 (83.6) | 0.006 * |
Treatment outcomes | |||
Complications | |||
Intraoperative, n (%) | 0 | 0 | - |
Postoperative, n (%) | 1 (2.6) | 2 (1.4) | 0.584 ‡ |
Reoperations, n (%) | 0 | 0 | - |
Operative time (min), median (IQR) | 50 (30, 65) | 30 (20, 40) | <0.001 § |
LOS (days), median (IQR) | 7 (6; 8) | 3 (2; 3) | <0.001 § |
Pathohistological analysis, n (%) | |||
Catarrhal appendicitis | 0 | 1 (0.7) | |
Phlegmonous appendicitis | 0 | 88 (60.3) | |
Gangrenous appendicitis | 38 (100) | 57 (39) |
Predictive Factor, n (%) | Group I | Group II | p * | |
---|---|---|---|---|
Perforated Appendicitis (n = 38) | Non-Perforated Appendicitis (n = 146) | |||
Vomiting | 28 (73.7) | 83 (56.8) | 0.059 | |
Pain in RIF | 38 (100) | 146 (100) | >0.999 | |
Axillary temperature ≥38.5 °C | 18 (47.4) | 16 (11) | <0.001 | |
Polymorphonuclear leukocytes | <70% | 2 (5.3) | 10 (6.8) | <0.001 |
70–84% | 10 (26.3) | 92 (63) | ||
≥85% | 26 (68.4) | 44 (30.2) | ||
CRP level | <10 mg/L | 1 (2.6) | 45 (30.8) | <0.001 |
10–49 mg/L | 9 (23.7) | 68 (46.6) | ||
≥50 mg/L | 28 (73.7) | 33 (22.6) | ||
WBC count | <10 × 109/L | 2 (5.3) | 23 (15.8) | <0.001 |
10–14.9 × 109/L | 12 (31.6) | 71 (48.6) | ||
≥15 × 109/L | 24 (63.2) | 52 (35.6) | ||
AIR score median (IQR) | 10 (9, 11) | 7 (6, 9) | <0.001 † |
n (%) | High Risk (Score ≥ 9) | Indeterminate Risk (Score 5–8) | Low Risk (Score < 5) |
---|---|---|---|
Non-perforated appendicitis | 40 (27.4) | 98 (67.1) | 8 (5.5) |
Perforated appendicitis | 33 (86.8) | 5 (13.2) | 0 |
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Pogorelić, Z.; Mihanović, J.; Ninčević, S.; Lukšić, B.; Elezović Baloević, S.; Polašek, O. Validity of Appendicitis Inflammatory Response Score in Distinguishing Perforated from Non-Perforated Appendicitis in Children. Children 2021, 8, 309. https://doi.org/10.3390/children8040309
Pogorelić Z, Mihanović J, Ninčević S, Lukšić B, Elezović Baloević S, Polašek O. Validity of Appendicitis Inflammatory Response Score in Distinguishing Perforated from Non-Perforated Appendicitis in Children. Children. 2021; 8(4):309. https://doi.org/10.3390/children8040309
Chicago/Turabian StylePogorelić, Zenon, Jakov Mihanović, Stipe Ninčević, Bruna Lukšić, Sara Elezović Baloević, and Ozren Polašek. 2021. "Validity of Appendicitis Inflammatory Response Score in Distinguishing Perforated from Non-Perforated Appendicitis in Children" Children 8, no. 4: 309. https://doi.org/10.3390/children8040309
APA StylePogorelić, Z., Mihanović, J., Ninčević, S., Lukšić, B., Elezović Baloević, S., & Polašek, O. (2021). Validity of Appendicitis Inflammatory Response Score in Distinguishing Perforated from Non-Perforated Appendicitis in Children. Children, 8(4), 309. https://doi.org/10.3390/children8040309