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conferenceseries
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Volume 8
Pediatrics & Therapeutics
ISSN: 2161-0665
Pediatrics and Pediatric Gastroenterology 2018
March 21-22, 2018
16
th
Annual World Congress on
3
rd
Annual World Congress on
March 21-22, 2018 | New York, USA
PEDIATRICS
PEDIATRIC NUTRITION,
GASTROENTEROLOGY & CHILD DEVELOPMENT
&
A pre-operative clinical scoring system to distinguish perforation risk with pediatric appendicitis
William Bonadio
Maimonides Medical Center, USA
Introduction:
Appendicitis is a common, potentially serious pediatric disease. An important factor in determining management
strategy (whether/when to perform appendectomy, duration of antibiotic therapy/hospitalization, etc.) and predicting outcome is
distinguishing whether perforation is present.
Objective:
The objective of this study was to determine efficacy of commonly assessed pre-operative variables in stratifying perforation
risk in children with appendicitis.
Design & Setting:
A retrospective analysis of consecutive cases was performed. A large urban hospital pediatric emergency
department participants includes 448 consecutive cases of CT (computerized tomography] confirmed pediatric appendicitis during a
six years period in an urban pediatric ED (emergency department): 162 with perforation and 286 non-perforated.
Main Outcome(s) & Measure(s):
To determine efficacy of clinical and laboratory variables with distinguishing perforation outcome
in children with appendicitis.
Results:
Regression analysis identified three independently significant variables associated with perforation outcome and determined
their ideal threshold values: duration of symptoms >1 day; ED-measured fever [body temperature >38.0 degrees C]; CBC WBC
absolute neutrophil count >13,000/mm3. The resulting multivariate ROC [receiver operating characteristic] curve after applying
these threshold values gave an AUC [area under curve] of 89% for perforation outcome [p<0.001]. Risk for perforation was additive
with each additional predictive variable exceeding its threshold value, linearly increasing from 7% with no variable present to 85%
when all three variables are present.
Conclusions:
A pre-operative scoring system comprised of three commonly assessed clinical/laboratory variables is useful in
stratifying perforation risk in children with appendicitis. Physicians can utilize these factors to gauge pre-operative risk for perforation
in children with appendicitis, which can potentially aid in planning subsequent management strategy.
william.bonadio@mountsinai.orgPediatr Ther 2018, Volume: 8
DOI: 10.4172/2161-0665-C1-049