Pediatric Appendicitis Score / Pediatric Appendicitis Risk Calculator / Alvarado - Which is Superior in Predicting the Incidence of Confirmed Appendicitis? (Diagnostic Test Overview)

Abstract

Background: Acute appendicitis is one of the most common causes of acute abdominal pain in children. The most severe complication is perforation of the appendix, which can lead to peritonitis and sepsis. Early diagnosis could prevent deterioration, therefore scoring systems were made to help clinicians to diagnose appendicitis.

Aim: This study aims to review the diagnostic test of the Alvarado, Pediatric Appendicitis Score (PAS), and Pediatric Appendicitis Risk Calculator (pARC) scoring systems in predicting the incidence of confirmed acute appendicitis in pediatrics.

Material and Methods: This study is an analytical study with a case-control study design and total sampling method. The accessible population is cases of acute appendicitis in children with a limited population in Depati Hamzah Regional Public Hospital from 1^st January 2019 to 31^st July 2020.

Results: PAS has the highest true-positive value (80%), followed by Alvarado score (55%), and pARC (30%). The results of sensitivity, specificity, PPV, and NPV between Alvarado scores and PAS were 68.75%; 100%; 100%; 44.44%. The results of sensitivity, specificity, PPV, and NPV between the pARC against the PAS were 37.5%; 100%; 100%; 71.43%. The results of sensitivity, specificity, PPV, and NPV between the pARC against the Alvarado score were 36.36%; 77.78%; 66.67%; 50%.

Conclusion: This study shows that Alvarado score has a better level of sensitivity, specificity, PPV, and NPV in predicting the incidence of acute appendicitis in confirmed children.

Keywords: acute appendicitis, PAS, pARC, Alvarado, pediatric