지원사업
학술연구/단체지원/교육 등 연구자 활동을 지속하도록 DBpia가 지원하고 있어요.
커뮤니티
연구자들이 자신의 연구와 전문성을 널리 알리고, 새로운 협력의 기회를 만들 수 있는 네트워킹 공간이에요.
논문 기본 정보
- 자료유형
- 학술저널
- 저자정보
- 발행연도
- 2018.1
- 수록면
- 54 - 61 (8page)
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Purpose: To develop a clinical scoring system for children with presumed appendicitis who visit the emergency department. Methods: A registry based-retrospective study was conducted in the pediatric emergency department between September 2015 and December 2016. Patients aged 4 to 17 years who had a > 1 of 5 Likert scale for possibility of appendicitis were included. Multiple logistic regressions based on Akaike information criterion were performed using variables regarding clinical features and inflammatory markers to develop the clinical scoring system. Results: A total of 233 patients were included, and 93 (39.9%) had the final diagnosis of appendicitis. The final model with the lowest Akaike information criterion (171.7) consisted of 5 variables, including vomiting (1 point), absence of watery diarrhea (1 point), duration of symptoms ≤ 3 days (1 point), rebound tenderness (1 point), and white blood cell count > 10.0 × 109/L (2 points). If the clinical score was ≥ 4 of 6 points, the area under the receiver operating characteristic curve was 0.78 (95% confidence interval, 0.71-0.86) with a 78.9% sensitivity, 66.7% specificity, positive and negative predictive values of 70.0% and 76.2%, respectively, and positive and negative likelihood ratios of 2.4 and 0.3, respectively. Conclusion: The 5-item clinical scoring system shows a fair performance for prediction of pediatric appendicitis. This simple tool could be applied to predict the pediatric appendicitis, and to avoid the use of potentially unnecessary computed tomography.
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참고문헌 (20)
참고문헌 신청
Lahaye MJ / 2015 / Mandatory imaging cuts costs and reduces the rate of unnecessary surgeries in the diagnostic work-up of patients suspected of having appendicitis / Eur Radiol 25:1464~1470
Boonstra PA / 2015 / Less negative appendectomies due to imaging in patients with suspected appendicitis / Surg Endosc 29:2365~2370
Bolmers MD / 2018 / Imaging in pediatric appendicitis is key to a low normal appendix percentage: a national audit on the outcome of appendectomy for appendicitis in children / Pediatr Surg Int 34:543~551
Krajewski S / 2011 / Impact of computed tomography of the abdomen on clinical outcomes in patients with acute right lower quadrant pain:a meta-analysis / Can J Surg 54:43~53
Martin AE / 2004 / CT scans may not reduce the negative appendectomy rate in children / J Pediatr Surg 39:886~890
Boonstra PA / 2015 / Less negative appendectomies due to imaging in patients with suspected appendicitis / Surg Endosc 29:2365~2370
Bolmers MD / 2018 / Imaging in pediatric appendicitis is key to a low normal appendix percentage: a national audit on the outcome of appendectomy for appendicitis in children / Pediatr Surg Int 34:543~551
Krajewski S / 2011 / Impact of computed tomography of the abdomen on clinical outcomes in patients with acute right lower quadrant pain:a meta-analysis / Can J Surg 54:43~53
Martin AE / 2004 / CT scans may not reduce the negative appendectomy rate in children / J Pediatr Surg 39:886~890
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