Application of a clinical score for the diagnosis of acute appendicitis in childhood: a retrospective analysis of 197 patients.

Abstract Purpose: The aim of this study was to validate a clinical scoring system for the diagnosis of acute appendicitis in childhood. Methods: The authors retrospectively applied a clinical scoring system on 197 consecutive pediatric patients operated on for acute appendicitis. They therefore looked for a correlation between the management suggested by the scoring system and pathologic diagnosis on surgical specimens. Results: Based on final pathologic specimen, surgery has been performed unnecessarily in 23% of cases. The proposed scoring system could have reduced unnecessary surgery to 2%. Only 8% of patients with acute appendicitis would have been discharged home. Sensitivity and specificity of the scoring system used in this study was 87% and 86%, respectively. Conclusion: The clinical scoring system proposed in this study could be of help in early clinical diagnosis of appendicitis to reduce the rate of unnecessary emergency surgery. J Pediatr Surg 35:1320-1322. Copyright © 2000 by W.B. Saunders Company.