Appendicitis in Children: Evaluation of the Pediatric Appendicitis Score in Younger and Older Children. (10th December 2014)

• Record Type: Journal Article
• Authors: Salö, Martin; Friman, Gustav; Stenström, Pernilla; Ohlsson, Bodil; Arnbjörnsson, Einar
• Other Names: Ziegler Moritz M. Academic Editor.
• Is Part Of: Surgery research and practice. Volume 2014(2014)
• Publication Date: 2014-12-10
• Subjects: Surgery -- Periodicals; 617.005
• DOI: 10.1155/2014/438076
• Languages: English
• ISSNs: 2356-7759

Abstract

Abstract : Background . This study aimed to evaluate Pediatric Appendicitis Score (PAS), diagnostic delay, and factors responsible for possible late diagnosis in children <4 years compared with older children who were operated on for suspected appendicitis. Method . 122 children, between 1 and 14 years, operated on with appendectomy for suspected appendicitis, were retrospectively analyzed. The cohort was divided into two age groups: ≥4 years (n = 102 ) and <4 years (n = 20 ). Results . The mean PAS was lower among the younger compared with the older patients (5.3 and 6.6, resp.;P = 0.005 ), despite the fact that younger children had more severe appendicitis (75.0% and 33.3%, resp.;P = 0.001 ). PAS had low sensitivity in both groups, with a significantly lower sensitivity among the younger patients. Parent and doctor delay were confirmed in children <4 years of age with appendicitis. PAS did not aid in patients with doctor delay. Parameters in patient history, symptoms, and abdominal examination were more diffuse in younger children. Conclusion . PAS should be used with caution when examining children younger than 4 years of age. Diffuse symptoms in younger children with acute appendicitis lead to delay and to later diagnosis and more complicated appendicitis.