What’s Known on This Subject Appendicitis is an acute inflammatory process that affects the appendix, one of the common causes of abdominal pain in children in emergency. Being one of the most common conditions faced by surgeons.

The PAS scale, a clinical score for acute appendicitis, is among the most popular for use in children for diagnosis. The severity of appendicitis subclassified as simple appendicitis (congested or suppurated) vs complicated appendicitis (gangrenous or perforated) could be predicted with a PAS scale ≥8.

What This Study Adds Tests logistic regression models as a basis for developing more complex models to improve prediction of complicated acute appendicitis in children.

Background The Pediatric Appendicitis Score (PAS) is a highly utilized diagnostic tool for acute appendicitis in pediatric patients. The severity of appendicitis subclassified as simple appendicitis (congested or suppurated) vs complicated appendicitis (gangrenous or perforated) could be predicted with a PAS scale ≥8.

Methods The type of study of the present research, according to Altman Douglas, is: Observational, Retrospective y Longitudinal. The design is cohort-type. The population was evaluated, 86 children aged 4-14 years with a preoperative diagnosis of appendicitis, grouped into 2 groups: complicated appendicitis (43) and simple appendicitis (43) exposed to the PAS≥8 or PAS 8.

Results The effectiveness of the PAS≥8 scale for diagnosing the severity of appendicitis showed a predictive diagnostic accuracy of 59.3% and increases the likelihood of severity by 2.246 times (CI:95% 0.917-5.50 p=0.077) in the predictive model. There were statistically significant differences in cough/hop/percussion Tenderness, migration of pain, anorexia, leukocytosis and neutrophilia, between scale PAS≥8 vs PAS<8.

Conclusion The PAS≥8 scale alone is not sufficient to diagnose the severity of acute appendicitis, with 59.3% predictive diagnostic accuracy and increasing the likelihood of presenting the severity of appendicitis by 2.246 times.

Competing Interest Statement

The authors have declared no competing interest.

Clinical Protocols

https://repositorio.unap.edu.pe/handle/20.500.14082/19832

Funding Statement

This study did not receive any funding

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Ethics committee/IRB of Full Institution Hospital Carlos Monge Medrano gave ethical approval for this work

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AbbreviationsPASPediatric appendicitis scoreIYYouden IndexUSAUnited StatesCRPC Reactive ProteinROCReceiver Operating CharacteristicAUCArea under the curvePPVPositive predictive valueNPVNegative predictive valuePMNPolymorphonuclearCIconfidence intervalSDstandard deviation