Key result
Longer symptom duration, leukocytosis, serum sodium <135 mEq/L, appendicolith, and free fluid/abscess on ultrasound were identified as predictors of perforated appendicitis in 58 children.
Why the study?
During the COVID-19 pandemic, operating on suspected perforated appendicitis while managing simple appendicitis conservatively was practiced, motivating a scoring system using clinical features and investigations to discriminate between perforated and non-perforated appendicitis in children.
Can clinical features and investigations reliably predict perforated appendicitis in children to guide operative versus conservative management?
Observational (n=58)
No
Can clinical features and investigations reliably predict perforated appendicitis in children to guide operative versus conservative management?
Answers are grounded in this paper and cite their sources.
A novel scoring system using clinical and sonographic features can reliably identify perforated appendicitis in children, aiding resource allocation during pandemics.
Purpose: During the coronavirus disease 2019 pandemic, with an aim to reduce the burden on the strained health care resources, operating on suspected perforated appendicitis while managing simple appendicitis conservatively was followed in our institution.The aim of this study was to determine the predictive value of clinical features and investigations for discriminating between perforated and non-perforated appendicitis in children and devise a scoring system.Methods: A retrospective study of all consecutive children who underwent appendectomy for acute appendicitis at our institution, a tertiary care pediatric center in South India, between 1st June 2020 to 31st May 2021 (period, one year) was carried out.In line with our standard operative procedure suspected perforated appendicitis were operated while simple appendicitis were managed conservatively in our institution.Patient demographics details, clinical features and investigations data were collected, and univariate and multivariate analysis carried out.Results: Total of 58 patients were included in the study.Longer duration of symptoms, leukocytosis, serum sodium <135 mEq/L, appendicolith and free fluid and abscess on ultrasonography are good predictors of perforated appendicitis.We have evolved a reliable scoring system to identify perforated appendicitis.Conclusion: Accurate identification perforated appendicitis with our scoring system is possible and results in effective usage of health care resources.
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LN et al. (2023) conducted an observational in Acute appendicitis (n=58). Clinical features and investigations was evaluated on Discrimination between perforated and non-perforated appendicitis. Longer symptom duration, leukocytosis, serum sodium <135 mEq/L, appendicolith, and free fluid/abscess on ultrasound were identified as predictors of perforated appendicitis in 58 children.
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