What is the clinical evidence from this study?

Study design: Cohort. Population: Acute appendicitis in children (n=1185). Intervention: Predictive nomogram (9 preoperative variables). Primary outcome: Discriminatory performance (AUC) for acute complicated appendicitis (AUC 0.906 (external validation)).

What does this research mean for the field?

A predictive nomogram incorporating nine preoperative clinical and laboratory variables accurately distinguishes between acute complicated and uncomplicated appendicitis in children. Novelty: ClaimNovelty.METHODOLOGICAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

This research aims to identify preoperative predictors for complicated appendicitis in children and develop a predictive nomogram.

July 23, 2026BMC PediatricsOpen Access

Nine-variable preoperative nomogram distinguishes complicated from uncomplicated pediatric appendicitis with ~0.91 AUC.

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Why the study?

Preoperative identification of pediatric patients at elevated risk for acute complicated appendicitis is needed to optimize surgical management and counseling.

Can a preoperative nomogram accurately predict acute complicated appendicitis in children?

Population

735 pediatric patients with acute appendicitis (training/internal validation) plus 450 external validation patients

Comparison

Acute complicated appendicitis vs uncomplicated appendicitis predictors

Design

Multicenter retrospective cohort study with external validation

Key result

A predictive nomogram incorporating nine preoperative variables effectively distinguished between acute complicated and uncomplicated appendicitis in children, with an external validation AUC of 0.906.

Authors

HMHonglong Ma JOJunjun Ouyang JLJ L Liu

Discussion

Member takes

Overview

May support preoperative risk stratification in pediatric appendicitis; hypothesis-generating and requires prospective validation before changing practice.

Key Points

This research aims to identify preoperative predictors for complicated appendicitis in children and develop a predictive nomogram.
Retrospective analysis of 735 pediatric patients diagnosed with acute appendicitis
Patients randomly divided into a training cohort and an internal validation cohort in a 7:3 ratio
External validation cohort included 450 patients, using LASSO regression and multivariate logistic regression for model development.
Nine predictors identified: neutrophil-to-lymphocyte ratio, C-reactive protein, serum chloride, fibrinogen, appendicolith, free peritoneal effusion, onset time, signs of peritoneal irritation, and fever (≥ 38 °C)
Nomogram achieved AUC values of 0.922, 0.916, and 0.906 for training, internal, and external validation cohorts, respectively
Demonstrated excellent calibration and clinical utility through decision curve analysis.

Study Design

Type

Cohort (n=1,185)

Multicenter

Yes

Structured PICO

Can a preoperative nomogram accurately predict acute complicated appendicitis in children?

Population

1,185 pediatric patients diagnosed with acute appendicitis who underwent surgical treatment, used to develop and validate a predictive nomogram for complicated appendicitis.

Exposure

Preoperative predictive nomogram incorporating 9 predictors (neutrophil-to-lymphocyte ratio, C-reactive protein level, serum chloride, fibrinogen, appendicolith, free peritoneal effusion, onset time, peritoneal irritation signs, and fever)

Outcome

Identification of acute complicated appendicitis

Main Result

Effect estimate: AUC 0.906 (external validation)

A newly developed preoperative nomogram using 9 clinical and laboratory variables can accurately distinguish between acute complicated and uncomplicated appendicitis in children.

Cite This Study

Ma et al. (2026) conducted a cohort in Acute appendicitis in children (n=1,185). Predictive nomogram (9 preoperative variables) was evaluated on Discriminatory performance (AUC) for acute complicated appendicitis (AUC 0.906 (external validation)). A predictive nomogram incorporating nine preoperative variables effectively distinguished between acute complicated and uncomplicated appendicitis in children, with an external validation AUC of 0.906.

synapsesocial.com/papers/6a61b004faa9903c5116abb8 https://doi.org/10.1186/s12887-026-07314-3

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July 23, 2026BMC PediatricsOpen Access

Nine-variable preoperative nomogram distinguishes complicated from uncomplicated pediatric appendicitis with ~0.91 AUC.

View Full Paper

Ask AI

Bookmark

Why the study?

Preoperative identification of pediatric patients at elevated risk for acute complicated appendicitis is needed to optimize surgical management and counseling.

Can a preoperative nomogram accurately predict acute complicated appendicitis in children?

Population

735 pediatric patients with acute appendicitis (training/internal validation) plus 450 external validation patients

Comparison

Acute complicated appendicitis vs uncomplicated appendicitis predictors

Design

Multicenter retrospective cohort study with external validation

Key result

Authors

HMHonglong Ma JOJunjun Ouyang JLJ L Liu

Discussion

Member takes

Overview

May support preoperative risk stratification in pediatric appendicitis; hypothesis-generating and requires prospective validation before changing practice.

Key Points

This research aims to identify preoperative predictors for complicated appendicitis in children and develop a predictive nomogram.
Retrospective analysis of 735 pediatric patients diagnosed with acute appendicitis
Patients randomly divided into a training cohort and an internal validation cohort in a 7:3 ratio
External validation cohort included 450 patients, using LASSO regression and multivariate logistic regression for model development.
Nine predictors identified: neutrophil-to-lymphocyte ratio, C-reactive protein, serum chloride, fibrinogen, appendicolith, free peritoneal effusion, onset time, signs of peritoneal irritation, and fever (≥ 38 °C)
Nomogram achieved AUC values of 0.922, 0.916, and 0.906 for training, internal, and external validation cohorts, respectively
Demonstrated excellent calibration and clinical utility through decision curve analysis.

Study Design

Type

Cohort (n=1,185)

Multicenter

Yes

Structured PICO

Can a preoperative nomogram accurately predict acute complicated appendicitis in children?

Population

1,185 pediatric patients diagnosed with acute appendicitis who underwent surgical treatment, used to develop and validate a predictive nomogram for complicated appendicitis.

Exposure

Outcome

Identification of acute complicated appendicitis

Main Result

Effect estimate: AUC 0.906 (external validation)

A newly developed preoperative nomogram using 9 clinical and laboratory variables can accurately distinguish between acute complicated and uncomplicated appendicitis in children.

Cite This Study

synapsesocial.com/papers/6a61b004faa9903c5116abb8 https://doi.org/10.1186/s12887-026-07314-3

Also Consider

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