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Validation of clinical prediction scores for pediatric appendicitis – update with new cutoff values for the AIR2 score
European Journal of Pediatric Surgery ( IF 1.8 ) Pub Date : 2022 , DOI: 10.1055/a-1932-8468
Johanna Gudjonsdottir 1 , Roland E Andersson 2, 3
Affiliation  

Gudjonsdottir et al validated four clinical prediction scores for appendicitis in children. The AIR score and pARC had the best performance. A recent validation of the AIR score (AIR2) recommended an adjustment of the low risk interval. With the new risk interval the PAS and AIR2 score assign about half of the no appendicitis patients to the low risk group with very high sensitivity for advanced appendicitis (0.97-0.99). Expectant management with planned reexamination, can thus safely be considered for this group. The AIR2 score and pARC both assign a smaller proportion of patients to the high risk groups (14 and 22%, respectively) but with high specificity (0.93 and 0.98). At such a high specificity a diagnostic laparoscopy should be considered before imaging, as a negative imaging study can probably not rule out appendicitis.



中文翻译:

小儿阑尾炎临床预测评分的验证——使用 AIR2 评分的新截止值进行更新

Gudjonsdottir 等人验证了儿童阑尾炎的四种临床预测评分。AIR 分数和 pARC 具有最佳性能。最近对 AIR 评分 (AIR2) 的验证建议调整低风险区间。根据新的风险区间,PAS 和 AIR2 评分将大约一半的无阑尾炎患者分配到低风险组,对晚期阑尾炎的敏感性非常高 (0.97-0.99)。因此,可以安全地考虑对这个群体进行有计划复查的期待治疗。AIR2 评分和 pARC 均将较小比例的患者分配到高风险组(分别为 14 和 22%),但具有高特异性(0.93 和 0.98)。鉴于如此高的特异性,在成像前应考虑诊断性腹腔镜检查,因为阴性成像研究可能不能排除阑尾炎。

更新日期:2022-10-12
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