The Significance of Combined Detection of Ultrasonography, Pediatric Appendicitis Score and C-Reactive Protein in the Diagnosis and Pathological Type of Acute Appendicitis in Children
Abstract:
Background: Timely diagnosis of acute appendicitis, a common acute abdominal condition, is crucial. This study assesses the diagnostic value of ultrasonography, Pediatric Appendicitis Score (PAS), and C-reactive protein (CRP) in children. Methods: A retrospective analysis of 268 children with acute abdominal pain between January 2017 and 2020 categorized them into acute and non-acute appendicitis groups based on pathology. The acute group was further classified into simple, suppurative, and gangrenous types.
Results: Among 150 patients with acute appendicitis, PAS and CRP were significantly higher than in the non-acute group. The AUCs for ultrasonography, PAS, and CRP were 0.897, 0.871, and 0.777, respectively. The combination of ultrasonography with PAS and CRP increased sensitivity and negative predictive value but reduced specificity and positive predictive value. In complicated appendicitis, CRP levels and the AUCs for CRP and ultrasonography were notably higher. The sensitivity for diagnosing complicated appendicitis with ultrasonography and CRP combined was 98.21%, superior to either alone. Ultrasonography sensitivities for various pathological types were 78.95%, 81.97%, and 92.16%, with diagnoses aligning with pathology (Kappa=0.888).
Conclusion: Combining ultrasonography, PAS, and CRP enhances the diagnosis of acute appendicitis in children and helps identify pathological subtypes, aiding clinical decision-making
