Retrospective Multivariate Analysis of Data from Children with Suspected Appendicitis: A New Tool for Diagnosis
Background. Decision-making for management may sometimes be difficult in acute appendicitis (AA). Various diagnostic scoring systems exist, but their sensitivity and specificity rates are far from ideal. In this study, the determination of the predictors and the effect of radiological data and devel...
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| Format: | Article |
| Language: | English |
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Wiley
2018-01-01
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| Series: | Emergency Medicine International |
| Online Access: | http://dx.doi.org/10.1155/2018/4810730 |
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| author | Zafer Dokumcu Bade Toker Kurtmen Emre Divarci Petek Bayindir Tamay Timur Kose Murat Sezak Geylani Ozok Orkan Ergun Ahmet Celik |
| author_facet | Zafer Dokumcu Bade Toker Kurtmen Emre Divarci Petek Bayindir Tamay Timur Kose Murat Sezak Geylani Ozok Orkan Ergun Ahmet Celik |
| author_sort | Zafer Dokumcu |
| collection | DOAJ |
| description | Background. Decision-making for management may sometimes be difficult in acute appendicitis (AA). Various diagnostic scoring systems exist, but their sensitivity and specificity rates are far from ideal. In this study, the determination of the predictors and the effect of radiological data and developing a new scoring system were aimed. Methods. Medical records of patients who were hospitalized for AA between February 2012 and October 2016 were retrospectively reviewed. All data were compared between patients with and without appendicitis. The multivariate analysis was performed to define significant variables and to examine the sensitivity and specificity of each group of predictors including radiological data. A new scoring system (NSS) was formed and was compared with two existing scoring systems: pediatric appendicitis score (PAS) and Alvarado scoring system (ASS) by using reclassification method. Results. Negative appendectomy rate was 11.3%. Statistical analysis identified 21 independently significant variables. The heel drop test had the highest odds ratio. Sensitivity and specificity rates of clinical predictors were 84.6% and 94.8%, respectively. Radiological predictors increased the sensitivity rate to 86.9%. Sensitivity and specificity rates for PAS, ASS, and NSS were 86.8% and 83.9%, 84.7% and 81.6%, and 96.8% and 95.6%, respectively. The “re-assessed negative appendectomy rate” was 6.2% and false positive results were remarkably more common in patients with duration of symptoms less than 24 hours. Conclusion. Radiological data improves the accuracy of diagnosis. Containing detailed clinical and radiological data, NSS performs superiorly to PAS and ASS, regarding sensitivity and specificity without any age limitation. The efficiency of NSS may be enhanced by determining different predictors for different phases of the inflammatory process. |
| format | Article |
| id | doaj-art-b42a610ee7744c28a26fb5ee3be85448 |
| institution | DOAJ |
| issn | 2090-2840 2090-2859 |
| language | English |
| publishDate | 2018-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Emergency Medicine International |
| spelling | doaj-art-b42a610ee7744c28a26fb5ee3be854482025-08-20T03:20:52ZengWileyEmergency Medicine International2090-28402090-28592018-01-01201810.1155/2018/48107304810730Retrospective Multivariate Analysis of Data from Children with Suspected Appendicitis: A New Tool for DiagnosisZafer Dokumcu0Bade Toker Kurtmen1Emre Divarci2Petek Bayindir Tamay3Timur Kose4Murat Sezak5Geylani Ozok6Orkan Ergun7Ahmet Celik8Ege University Faculty of Medicine Department of Pediatric Surgery, Izmir, TurkeyEge University Faculty of Medicine Department of Pediatric Surgery, Izmir, TurkeyEge University Faculty of Medicine Department of Pediatric Surgery, Izmir, TurkeyEge University Faculty of Medicine Department of Radiology, Division of Pediatric Radiology, Izmir, TurkeyEge University Faculty of Medicine Department of Biostatistics and Medical Informatics, Izmir, TurkeyEge University Faculty of Medicine Department of Pathology, Izmir, TurkeyEge University Faculty of Medicine Department of Pediatric Surgery, Izmir, TurkeyEge University Faculty of Medicine Department of Pediatric Surgery, Izmir, TurkeyEge University Faculty of Medicine Department of Pediatric Surgery, Izmir, TurkeyBackground. Decision-making for management may sometimes be difficult in acute appendicitis (AA). Various diagnostic scoring systems exist, but their sensitivity and specificity rates are far from ideal. In this study, the determination of the predictors and the effect of radiological data and developing a new scoring system were aimed. Methods. Medical records of patients who were hospitalized for AA between February 2012 and October 2016 were retrospectively reviewed. All data were compared between patients with and without appendicitis. The multivariate analysis was performed to define significant variables and to examine the sensitivity and specificity of each group of predictors including radiological data. A new scoring system (NSS) was formed and was compared with two existing scoring systems: pediatric appendicitis score (PAS) and Alvarado scoring system (ASS) by using reclassification method. Results. Negative appendectomy rate was 11.3%. Statistical analysis identified 21 independently significant variables. The heel drop test had the highest odds ratio. Sensitivity and specificity rates of clinical predictors were 84.6% and 94.8%, respectively. Radiological predictors increased the sensitivity rate to 86.9%. Sensitivity and specificity rates for PAS, ASS, and NSS were 86.8% and 83.9%, 84.7% and 81.6%, and 96.8% and 95.6%, respectively. The “re-assessed negative appendectomy rate” was 6.2% and false positive results were remarkably more common in patients with duration of symptoms less than 24 hours. Conclusion. Radiological data improves the accuracy of diagnosis. Containing detailed clinical and radiological data, NSS performs superiorly to PAS and ASS, regarding sensitivity and specificity without any age limitation. The efficiency of NSS may be enhanced by determining different predictors for different phases of the inflammatory process.http://dx.doi.org/10.1155/2018/4810730 |
| spellingShingle | Zafer Dokumcu Bade Toker Kurtmen Emre Divarci Petek Bayindir Tamay Timur Kose Murat Sezak Geylani Ozok Orkan Ergun Ahmet Celik Retrospective Multivariate Analysis of Data from Children with Suspected Appendicitis: A New Tool for Diagnosis Emergency Medicine International |
| title | Retrospective Multivariate Analysis of Data from Children with Suspected Appendicitis: A New Tool for Diagnosis |
| title_full | Retrospective Multivariate Analysis of Data from Children with Suspected Appendicitis: A New Tool for Diagnosis |
| title_fullStr | Retrospective Multivariate Analysis of Data from Children with Suspected Appendicitis: A New Tool for Diagnosis |
| title_full_unstemmed | Retrospective Multivariate Analysis of Data from Children with Suspected Appendicitis: A New Tool for Diagnosis |
| title_short | Retrospective Multivariate Analysis of Data from Children with Suspected Appendicitis: A New Tool for Diagnosis |
| title_sort | retrospective multivariate analysis of data from children with suspected appendicitis a new tool for diagnosis |
| url | http://dx.doi.org/10.1155/2018/4810730 |
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