Validity of pediatric appendicitis score in predicting disease severity in pediatric acute appendicitis

Objective: This study aims to evaluate the validity of Pediatric Appendicitis Score in predicting disease severity of acute pediatric appendicitis. Methods: We prospectively evaluated 120 children who underwent surgery for acute appendicitis. We enrolled them into two groups: uncomplicated appendicitis (n = 86) or complicated appendicitis (n = 34). We compared the age, blood test results, body temperature, hospital stay, number of complications, and pediatric appendicitis score between the two groups. We evaluated the diagnostic value (specificity, sensitivity, negative predictive and, positive predictive value), and value of the PAS to distinguish complicated from uncomplicated appendicitis. A receiver operating characteristic curve (ROC) was produced to find the appropriate cut-off value to distinguish complicated from uncomplicated appendicitis. To explore the severity of the disease, we divided the pediatric patients into two groups according to that cut-off value. Results: There were significant differences in the PAS score between uncomplicated and complicated appendicitis (5.7 versus 7.8). The ROC showed a PAS cut-off value of 8. A PAS >= 8 had a sensitivity of 73.1%, a specificity of 89.2%, a positive predictive value of 91.4%, and a negative predictive value of 68.5%. A PAS >= 8 was correlated with significantly more extended hospital stay and more complications than a PAS < 8. Conclusions: The pediatric appendicitis score (PAS) may be correlated with disease severity in acute pediatric appendicitis.