우하복통 등록체계를 이용한 소아 충수염 점수의 전향적 평가

Abstract

Purpose: Acute appendicitis is one of the most commonsurgical emergencies in the emergency department (ED)and various scoring systems such as the Alvarado score orthe pediatric appendicitis score (PAS) have been developedto aid diagnosis. This study was designed to evaluatethe diagnostic value of PAS in South Korea children,prospectively. Methods: All patients visiting our ED with right lower quadrant(RLQ) abdominal pain or RLQ tenderness wereenrolled in our registry. Patients under age of 18, whoseguardian agreed with the informed consent were included inthis study. Those who were diagnosed at previous hospitalswere excluded. Appendicitis was confirmed by operativeand histopathological findings. A follow up call was made toverify final outcome within 14 days. Results: We collected data on 1648 patients and a total of512 patients participated in the study. The mean age was11.9 years. Seventy four patients (14.5%) had pathologyprovenappendicitis and negative appendectomy was performedin three patients (3.9%). Statistical analysis showedthat with PAS ≥4, sensitivity 70.1%, specificity 60.4%, andarea under curve (AUC) 0.708. With the Alvarado score ≥5, sensitivity 72.7%, specificity 67.2%, and AUC 0.748. Conclusion: Usefulness of PAS in diagnosis of pediatricacute appendicitis is limited. PAS showed no significantsuperiority over the Alvarado score. Therefore, it seemsreasonable to use both scores for evaluation of pediatricacute appendicitis in South Korea.