Abstract
Purpose
This study aimed to determine whether routine urinalysis may serve as a tool in discriminating
between acute appendicitis and perforated appendicitis in children.
Basic procedures
We prospectively collected 357 patients with clinically suspected acute appendicitis.
Urinalysis was performed in patients with clinically suspected acute appendicitis
before surgical intervention. Routine urinalysis is composed of 2 examinations: chemical
tests for abnormal chemical constituents and microscopic tests for abnormal insoluble
constituents. Receiver operating characteristic curves for urine white blood cell
(WBC) counts and urine red blood cell (RBC) counts in distinguishing between patients
with simple appendicitis and patients with perforated appendicitis were also analyzed.
Main findings
Urine ketone bodies, leukocyte esterase, specific gravity, pH, WBC, and RBC counts
were all significant parameters among patients with normal appendices, simple appendicitis,
and perforated appendicitis (all P < .05). Based on multivariate logistic regression analysis, positive urine ketone
bodies and nitrate were significant parameters in predicting perforated appendicitis
(P = .002 and P = .008, respectively). According to the results of receiver operating characteristic
curves, the appropriate cutoff values were 2.0/high-power field for urine RBC counts
and 4.0/high-power field for urine WBC counts in predicting perforated appendicitis
in children.
Principal conclusions
Routine urinalysis may serve to aid in discriminating between simple and perforated
appendicitis. Clinically, we believe that these urine parameters may aid primary emergency
physicians with decision making in patients with clinically suspected appendicitis.
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Article Info
Publication History
Published online: September 23, 2013
Accepted:
June 17,
2013
Received in revised form:
June 15,
2013
Received:
May 20,
2013
Identification
Copyright
© 2013 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
