Predictive value of C-reactive protein, ultrasound and Alvarado score in acute appendicitis: a prospective pediatric cohort

Mohamed Zouari; Mohamed Jallouli; Hamdi Louati; Rim Kchaou; Rahma Chtourou; Ahmed Kotti; Mahdi Ben Dhaou; Hayet Zitouni; Riadh Mhiri

doi:10.1016/j.ajem.2015.10.004

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Predictive value of C-reactive protein, ultrasound and Alvarado score in acute appendicitis: a prospective pediatric cohort☆☆☆★

Mohamed Zouari, MD

Mohamed Jallouli, MD

Hamdi Louati, MD

Rim Kchaou, MD

Rahma Chtourou, MD

Ahmed Kotti, MD

Mahdi Ben Dhaou, MD

Hayet Zitouni, MD

Riadh Mhiri, MD

Department of pediatric surgery, Hedi Chaker Hospital, 3029 Sfax, Tunisia

DOI: http://dx.doi.org/10.1016/j.ajem.2015.10.004

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Abstract

Purpose

To evaluate whether C-reactive protein (CRP) level and ultrasound (US) results on admission could aid the diagnostic accuracy of Alvarado score.

Methods

A prospective study was performed on children <14 years admitted for suspected acute appendicitis. Patients were categorized into three groups based on the Alvarado score: group I: score 7-10, group II: score 5-6, group III: score 0-4.

Results

The difference between predictive values of Alvarado score alone and Alvarado score with CRP was not statically significant. The PPV increased from 74.29% (Alvarado score and CRP) to 93.75% (Alvarado score and US) in group 1 (P = .001) and the NPV increased from 64.86 and 79.69% (Alvarado score and CRP) to 82.6 and 88.2% (Alvarado score and US) in group 2 (P = .01) and group 3 (P = .001), respectively.

Conclusions

Alvarado score and ultrasound taken together improve the predictive value of diagnosing acute appendicitis in children.

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☆Conflict of Interest: None.

☆☆Mohamed Zouari, Mohamed Jallouli, Hamdi Louati, Rim Kchaou, Rahma Chtourou, Ahmed Kotti, Mahdi Ben Dhaou, Hayet Zitouni, and Riadh Mhiri declare that they have no conflict of interest.

★Source of Support: Nil.

Predictive value of C-reactive protein, ultrasound and Alvarado score in acute appendicitis: a prospective pediatric cohort☆☆☆★

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Article Info

Abstract

Purpose

Methods

Results

Conclusions

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