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Ultrasound for Appendicitis: Performance and Integration with Clinical Parameters

Objective. To evaluate the performance of ultrasound in pediatric appendicitis and the integration of US with the pediatric appendicitis score (PAS) and C-reactive protein (CRP). Method. An institution-based, retrospective study of children who underwent abdominal US for suspected appendicitis betwe...

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Autores principales: Löfvenberg, Fanny, Salö, Martin
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Hindawi Publishing Corporation 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5156797/
https://www.ncbi.nlm.nih.gov/pubmed/28044133
http://dx.doi.org/10.1155/2016/5697692
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author Löfvenberg, Fanny
Salö, Martin
author_facet Löfvenberg, Fanny
Salö, Martin
author_sort Löfvenberg, Fanny
collection PubMed
description Objective. To evaluate the performance of ultrasound in pediatric appendicitis and the integration of US with the pediatric appendicitis score (PAS) and C-reactive protein (CRP). Method. An institution-based, retrospective study of children who underwent abdominal US for suspected appendicitis between 2012 and 2015 at a tertiary pediatric surgery center. US results were dichotomized, with a nonvisualized appendix considered as a negative examination. Results. In total, 438 children were included (mean 8.5 years, 54% boys), with an appendicitis rate of 29%. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) for US were 82%, 97%, 92%, and 93%, respectively, without significant age or gender differences. Pediatric radiologists had significantly higher sensitivity compared to general radiologists, 88% and 71%, respectively (p < 0.01), but no differences were seen for specificity, PPV, and NPV. The sensitivity, NPV, and negative likelihood ratio for the combination of negative US, PAS < 5, and CRP < 5 mg/L were 98%, 98%, and 0.05 (95% CI 0.03–0.15). Conclusion. US may be a useful tool for evaluating children with suspected appendicitis, regardless of age or gender, and should be the first choice of imaging modalities. Combining US with PAS and CRP may reduce several unnecessary admissions for in-hospital observation.
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spelling pubmed-51567972017-01-02 Ultrasound for Appendicitis: Performance and Integration with Clinical Parameters Löfvenberg, Fanny Salö, Martin Biomed Res Int Clinical Study Objective. To evaluate the performance of ultrasound in pediatric appendicitis and the integration of US with the pediatric appendicitis score (PAS) and C-reactive protein (CRP). Method. An institution-based, retrospective study of children who underwent abdominal US for suspected appendicitis between 2012 and 2015 at a tertiary pediatric surgery center. US results were dichotomized, with a nonvisualized appendix considered as a negative examination. Results. In total, 438 children were included (mean 8.5 years, 54% boys), with an appendicitis rate of 29%. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) for US were 82%, 97%, 92%, and 93%, respectively, without significant age or gender differences. Pediatric radiologists had significantly higher sensitivity compared to general radiologists, 88% and 71%, respectively (p < 0.01), but no differences were seen for specificity, PPV, and NPV. The sensitivity, NPV, and negative likelihood ratio for the combination of negative US, PAS < 5, and CRP < 5 mg/L were 98%, 98%, and 0.05 (95% CI 0.03–0.15). Conclusion. US may be a useful tool for evaluating children with suspected appendicitis, regardless of age or gender, and should be the first choice of imaging modalities. Combining US with PAS and CRP may reduce several unnecessary admissions for in-hospital observation. Hindawi Publishing Corporation 2016 2016-12-01 /pmc/articles/PMC5156797/ /pubmed/28044133 http://dx.doi.org/10.1155/2016/5697692 Text en Copyright © 2016 F. Löfvenberg and M. Salö. https://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Clinical Study
Löfvenberg, Fanny
Salö, Martin
Ultrasound for Appendicitis: Performance and Integration with Clinical Parameters
title Ultrasound for Appendicitis: Performance and Integration with Clinical Parameters
title_full Ultrasound for Appendicitis: Performance and Integration with Clinical Parameters
title_fullStr Ultrasound for Appendicitis: Performance and Integration with Clinical Parameters
title_full_unstemmed Ultrasound for Appendicitis: Performance and Integration with Clinical Parameters
title_short Ultrasound for Appendicitis: Performance and Integration with Clinical Parameters
title_sort ultrasound for appendicitis: performance and integration with clinical parameters
topic Clinical Study
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5156797/
https://www.ncbi.nlm.nih.gov/pubmed/28044133
http://dx.doi.org/10.1155/2016/5697692
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