Introduction:

Alvarado scale and the pediatric appendicitis scale are used for the stratification of pediatric patients with suspected appendicitis.

Objective:

Compare the diagnostic performance of these scales in schoolchildren and adolescents, in general and according to age and sex.

Methods:

Prospective observational study of 452 patients between 5 and 18 years of age, admitted to Centro Habana Pediatric Teaching Hospital due to abdominal pain or acute appendicitis in the period 2016-2017.

Results:

Alvarado scale had at <4 points: sensitivity 99.14 %, negative likelihood ratio 0.02; at >7 points: specificity 96.15 %, positive likelihood ratio 10.3. The paediatric appendicitis scale presented at <5 points: sensitivity 96.55 %, negative likelihood ratio 0.07; at >8 points: specificity 96.15 %, positive likelihood ratio 5.60. The areas under the curve had a similar overall (0.851 - 0.858), being higher and similar to each other in male schoolchildren (0.918 - 0.923). In female adolescents, the area under the curve for the pediatric appendicitis scale (0.841) was greater than for Alvarado's (0.802).

Conclusions:

Alvarado scale is more specific, while the pediatric appendicitis scale is more sensitive. Different cut-off points should be considered for each scale when stratifying according to probable appendicitis. Discriminative performance behaves similar in general for both scales, and very well in male schoolchildren. The biggest difference in performance occurs in female adolescents, in favor of the pediatric appendicitis scale.

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