SciELO - Scientific Electronic Library Online

 
vol.91 issue4Instrument for the screening of psychomotor development's problems in children under six years oldClinic-epidemiological description according to the age of patients diagnosed with cholera author indexsubject indexarticles search
Home Pagealphabetic serial listing  

Services on Demand

Journal

Article

Indicators

  • Have no cited articlesCited by SciELO

Related links

  • Have no similar articlesSimilars in SciELO

Share


Revista Cubana de Pediatría

Print version ISSN 0034-7531On-line version ISSN 1561-3119

Abstract

RAMIREZ GUIRADO, Alejandro; NAVARRO SOMBERT, Ana Barbarita  and  GAMEZ FONTS, Ledicel Nilo. Diagnostic performance of Alvarado score for acute appendicitis in children. Rev Cubana Pediatr [online]. 2019, vol.91, n.4, e816.  Epub Dec 03, 2019. ISSN 0034-7531.

Introduction:

The diagnosis of acute appendicitis in children is although frequent still challenging and in despite of the higher clinical experience and the more effective laboratory and imaging studies.

Objective:

To determine the diagnostic performance of Alvarado score for acute appendicitis in children.

Methods:

An observational, analytic and prospective study was conducted on 452 patients aged from 5 to 18 years old whom were admitted to the Pediatric Surgery service of Centro Habana Pediatric Hospital from January 2016 to January 2017 with a diagnosis of abdominal pain or acute appendicitis,

Results:

77.0% of admitted patients had diagnosis of appendicitis. The specificity and positive predictive value of the score were 0.90 and 0.95, respectively, considering 7 as the cutoff point; however, the sensitivity, the negative predictive value and the diagnostic accuracy had low values. The most balanced cutoff point was determined to be 6. Only 3 positive cases had scores under 4. The area under the Receiver Operating Characteristics Curve was 0.85.

Conclusions:

The score had good specificity and positive predictive value, as well as an acceptable general discriminative performance. However, it didn’t result appropriate as a unique tool for diagnosing acute appendicitis in the clinical setting. Nevertheless, it would be useful for ruling out the condition with a high level of certainty.

Keywords : appendicitis; Alvarado score; clinical prediction rules.

        · abstract in Spanish     · text in Spanish     · Spanish ( pdf )