An Effective Method for Diagnosing Appendicitis in Children: Appendicitis Scoring System

INTRODUCTION: This study aims to examine the diagnostic values of physical examination, laboratory and imaging methods of pediatric patients, who were hospitalized, followed up and operated in the pediatric surgery clinic of our hospital with the diagnosis of acute appendicitis, to investigate a simple and useful scoring system that can be formed from those with the highest diagnostic value, and to compare scoring systems concerning their effectiveness in diagnosing appendicitis and reducing negative appendectomy rates.
METHODS: The study group consisted of patients hospitalized and treated at the pediatric surgery clinic with a preliminary diagnosis of acute appendicitis between January 2016 and January 2019. The cases were divided into two different groups as appendicitis group (AG) and non-appendicitis group (NAG). Alvarado Appendicitis Score (AAS), Pediatric Appendicitis Score (PAS) and Tzanakis Appendicitis Score (TAS) of the patients were calculated retrospectively in both groups.
RESULTS: The difference between the PAS, AAS and TAS of AG and NAG was statistically significant (p=0.042, p=0.021 and p=0.021, respectively). The rate of neutrophil-to-lymphocyte ratio of >3.5 in 53 (77.9%) of the AG group and 33 (63.4%) of NAG was higher than 3.5 (p=0.030).
DISCUSSION AND CONCLUSION: This study has shown that appendicitis scoring methods are as effective as imaging techniques in the diagnosis of appendicitis, which is the most common cause of surgical abdominal pain in children admitting to emergency care units due to abdominal pain, as well as in reducing the negative appendectomy rates.