Predictive value of C-reactive protein, ultrasound and Alvarado score in acute appendicitis: a prospective pediatric cohort

Abstract Purpose To evaluate whether C-reactive protein (CRP) level and ultrasound (US) results on admission could aid the diagnostic accuracy of Alvarado score. Methods A prospective study was performed on children < 14 years admitted for suspected acute appendicitis. Patients were categorized i...

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Bibliographic Details
Published in:The American journal of emergency medicine 2016-02, Vol.34 (2), p.189-192
Main Authors: Zouari, Mohamed, MD, Jallouli, Mohamed, MD, Louati, Hamdi, MD, Kchaou, Rim, MD, Chtourou, Rahma, MD, Kotti, Ahmed, MD, Dhaou, Mahdi Ben, MD, Zitouni, Hayet, MD, Mhiri, Riadh, MD
Format: Article
Language:English
Subjects:
Accuracy
Adolescent
Appendicitis
Appendicitis - blood
Appendicitis - diagnostic imaging
C-Reactive Protein - metabolism
Child
Child, Preschool
Confidence intervals
Emergency
Emergency medical care
Female
Hospitals
Humans
Laboratories
Male
Medical imaging
Pain
Pediatrics
Predictive Value of Tests
Prospective Studies
Proteins
Sensitivity and Specificity
Surgery
Ultrasonic imaging
Ultrasonography
Values
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Summary:Abstract Purpose To evaluate whether C-reactive protein (CRP) level and ultrasound (US) results on admission could aid the diagnostic accuracy of Alvarado score. Methods A prospective study was performed on children < 14 years admitted for suspected acute appendicitis. Patients were categorized into three groups based on the Alvarado score: group I: score 7-10, group II: score 5-6, group III: score 0-4. Results The difference between predictive values of Alvarado score alone and Alvarado score with CRP was not statically significant. The PPV increased from 74.29% (Alvarado score and CRP) to 93.75% (Alvarado score and US) in group 1 ( P = .001) and the NPV increased from 64.86 and 79.69% (Alvarado score and CRP) to 82.6 and 88.2% (Alvarado score and US) in group 2 ( P = .01) and group 3 ( P = .001), respectively. Conclusions Alvarado score and ultrasound taken together improve the predictive value of diagnosing acute appendicitis in children.
ISSN:0735-6757
1532-8171
DOI:10.1016/j.ajem.2015.10.004