| Introduction: Acute appendicitis in children is associated with morbidity
and mortality due to late diagnosis. Several scoring systems, such as
Alvarado and PAS have been developed to help diagnose acute appendicitis
in children to make the most accurate and prompt decision. The purpose
of this study was to compare the efficacy and diagnostic value of these
scoring systems.
Materials and Methods: In this cross-sectional study, 130 children aged
5-14 with suspected acute appendicitis were included. After the collection
of demographic data, all patients were scored by Alvarado and PAS systems.
The decision for surgery was made by a surgeon, independently of these
scores. The diagnosis of acute appendicitis was affirmed by surgical and
pathologic findings.
Results: Male: Female ratio was 1.32:1, and the average age of the
patients were 9.2±2.7 years. The mean Alvarado and PAS scores were
higher in patients with positive pathologic findings. Neutrophilia >75%
and RLQ tenderness had the highest relationship with the diagnosis of the
disease. The diagnostic value of Alvarado was higher than PAS concerning
the area under the ROC curve. The cutoff point of 7 was associated with a
sensitivity of 74.5% and specificity of 66.7% for the Alvarado score, and a
sensitivity of 58.5% and specificity of 79.2% for the PAS score.
Conclusions: The results showed the high sensitivity of Alvarado and the
high specificity of PAS. However, the sensitivity, specificity, PPV, and NPV of
these criteria were not satisfactory for the confirmation of the diagnosis. |