Novel Pediatric Appendicitis Risk Calculator Accurately IDs Risk
WEDNESDAY, March 14, 2018 -- The pediatric appendicitis risk calculator (pARC) accurately quantifies the risk for appendicitis in a validation cohort of patients with acute abdominal pain, according to a study published online March 13 in Pediatrics.
Anupam B. Kharbanda, M.D., from Children's Minnesota in Minneapolis, and colleagues developed the pARC in a derivation sample that included visits to nine pediatric emergency departments between March 2009 and April 2010 (2,423 children; 40 percent with appendicitis). The calculator was validated in a sample that included visits to a single pediatric emergency department from 2003 to 2004 and from 2013 to 2015 (1,426 children; 35 percent with appendicitis).
The researchers included sex, age, duration of pain, guarding, pain migration, maximal tenderness in the right-lower quadrant, and absolute neutrophil count in the final pARC model. The pARC showed near perfect calibration in the validation sample as well as a high degree of discrimination (area under the curve, 0.85). When compared with the Pediatric Appendicitis Score (PAS), pARC outperformed the PAS (area under the curve, 0.77). Almost half of patients in the validation cohort could be accurately classified as at <15 percent risk or ≥85 percent risk for appendicitis by using the pARC, while only 23 percent would be identified as having comparable PAS of <3 or >8.
"In our validation cohort of patients with acute abdominal pain, the pARC accurately quantified risk for appendicitis," the authors write.
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Posted: March 2018