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Ultrasound for appendicitis : Performance and integration with clinical parameters

Löfvenberg, Fanny and Salö, Martin LU (2016) In BioMed Research International 2016.
Abstract

Objective. To evaluate the performance of ultrasound in pediatric appendicitis and the integration of US with the pediatric appendicitis score (PAS) and C-reactive protein (CRP). Method. An institution-based, retrospective study of children who underwent abdominal US for suspected appendicitis between 2012 and 2015 at a tertiary pediatric surgery center. US results were dichotomized, with a nonvisualized appendix considered as a negative examination. Results. In total, 438 children were included (mean 8.5 years, 54% boys), with an appendicitis rate of 29%. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) for US were 82%, 97%, 92%, and 93%, respectively, without significant age or gender... (More)

Objective. To evaluate the performance of ultrasound in pediatric appendicitis and the integration of US with the pediatric appendicitis score (PAS) and C-reactive protein (CRP). Method. An institution-based, retrospective study of children who underwent abdominal US for suspected appendicitis between 2012 and 2015 at a tertiary pediatric surgery center. US results were dichotomized, with a nonvisualized appendix considered as a negative examination. Results. In total, 438 children were included (mean 8.5 years, 54% boys), with an appendicitis rate of 29%. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) for US were 82%, 97%, 92%, and 93%, respectively, without significant age or gender differences. Pediatric radiologists had significantly higher sensitivity compared to general radiologists, 88% and 71%, respectively (p<0.01), but no differences were seen for specificity, PPV, and NPV. The sensitivity, NPV, and negative likelihood ratio for the combination of negative US, PAS < 5, and CRP < 5 mg/L were 98%, 98%, and 0.05 (95% CI 0.03-0.15). Conclusion. US may be a useful tool for evaluating children with suspected appendicitis, regardless of age or gender, and should be the first choice of imaging modalities. Combining US with PAS and CRP may reduce several unnecessary admissions for in-hospital observation.

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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
BioMed Research International
volume
2016
publisher
Hindawi Publishing Corporation
external identifiers
  • scopus:85006108553
  • wos:000389941300001
ISSN
2314-6133
DOI
10.1155/2016/5697692
language
English
LU publication?
yes
id
46effae4-b63d-4bda-bd87-1b146ce3d0a1
date added to LUP
2017-02-24 13:32:52
date last changed
2017-09-18 11:35:17
@article{46effae4-b63d-4bda-bd87-1b146ce3d0a1,
  abstract     = {<p>Objective. To evaluate the performance of ultrasound in pediatric appendicitis and the integration of US with the pediatric appendicitis score (PAS) and C-reactive protein (CRP). Method. An institution-based, retrospective study of children who underwent abdominal US for suspected appendicitis between 2012 and 2015 at a tertiary pediatric surgery center. US results were dichotomized, with a nonvisualized appendix considered as a negative examination. Results. In total, 438 children were included (mean 8.5 years, 54% boys), with an appendicitis rate of 29%. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) for US were 82%, 97%, 92%, and 93%, respectively, without significant age or gender differences. Pediatric radiologists had significantly higher sensitivity compared to general radiologists, 88% and 71%, respectively (p&lt;0.01), but no differences were seen for specificity, PPV, and NPV. The sensitivity, NPV, and negative likelihood ratio for the combination of negative US, PAS &lt; 5, and CRP &lt; 5 mg/L were 98%, 98%, and 0.05 (95% CI 0.03-0.15). Conclusion. US may be a useful tool for evaluating children with suspected appendicitis, regardless of age or gender, and should be the first choice of imaging modalities. Combining US with PAS and CRP may reduce several unnecessary admissions for in-hospital observation.</p>},
  articleno    = {5697692},
  author       = {Löfvenberg, Fanny and Salö, Martin},
  issn         = {2314-6133},
  language     = {eng},
  publisher    = {Hindawi Publishing Corporation},
  series       = {BioMed Research International},
  title        = {Ultrasound for appendicitis : Performance and integration with clinical parameters},
  url          = {http://dx.doi.org/10.1155/2016/5697692},
  volume       = {2016},
  year         = {2016},
}