Evidence map›Paper›PMID 36495332›Full record

ArticlePediatric surgery international2022

Alterations and diagnostic performance of capillary ketonemia in pediatric acute appendicitis: a pilot study.

Javier Arredondo Montero, Mónica Bronte Anaut, Carlos Bardají Pascual, Giuseppa Antona, Natalia López-Andrés, Nerea Martín-Calvo

Open access · hybridAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Pediatric surgery international, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 2 pooled it
0.8field-weighted citation impact, top 24% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 2 syntheses or guidelines pooled it, 7 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 3 institutions in 1 country.

Javier Arredondo MonteroPediatric Surgery Department, Hospital Universitario de Navarra, Calle Irunlarrea 3, 31008, Pamplona, Navarra, Spain. jarredondom@alumni.unav.es.
Mónica Bronte AnautPathology Department, Hospital Universitario de Araba, Vitoria, Spain.
Carlos Bardají PascualPediatric Surgery Department, Hospital Universitario de Navarra, Calle Irunlarrea 3, 31008, Pamplona, Navarra, Spain.
Giuseppa AntonaPediatric Surgery Department, Hospital Universitario de Navarra, Calle Irunlarrea 3, 31008, Pamplona, Navarra, Spain.
Natalia López-AndrésCardiovascular Translational Research, NavarraBiomed (Miguel Servet Foundation), Hospital Universitario de Navarra, Universidad Pública de Navarra (UPNA), IdiSNA, Pamplona, Navarra, Spain.
Nerea Martín-CalvoSchool of Medicine, Department of Preventive Medicine and Public Health, University of Navarra, Pamplona, Spain.
Hospital Universitario Araba · ESNavarre Institute of Health Research · ESUniversidad Publica de Navarra · ES

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionThe diagnostic performance of capillary ketonemia (CK) has been previously evaluated in context of pediatric acute gastroenteritis. To our knowledge, there is no literature on its performance in the setting of pediatric acute appendicitis (PAA). MATERIALS AND

methodsIn this study, 151 patients were prospectively included and divided into two groups: (1) patients with non-surgical abdominal pain in whom the diagnosis of PAA was excluded (n = 53) and (2) patients with a confirmed diagnosis of PAA (n = 98). In 80 patients (Group 1, n = 23 and group 2, n = 57) a CK was measured at the time of diagnosis. The PAA group was further classified into complicated (n = 18) and uncomplicated PAA (n = 39). Quantitative variables were compared between groups using the Mann-Whitney U test. Diagnostic performance of CK was evaluated with ROC curves.

resultsCK values were 0.3 [0.1-0.9] mmol/L in group 1 and 0.7 [0.4-1.4] mmol/L in group 2 (p = 0.01). Regarding the type of PAA, CK values were 0.6 [0.4-0.9] mmol/L in uncomplicated PAA and 1.2 [0.8-1.4] mmol/L in complicated PAA (p = 0.02). The AUC for the discrimination between groups 1 and 2 was 0.68 (95% IC 0.53-0.82) (p = 0.24) and the AUC for the discrimination between uncomplicated PAA and complicated PAA was 0.69 (95% IC 0.54-0.85) (p = 0.04). The best cut-off point (group 1 vs group 2) resulted in 0.4 mmol/L, with a sensitivity of 80.7% and a specificity of 52.2%. The best cut-off point (non-complicated vs complicated PAA) resulted in 1.1 mmol/L, with a sensitivity of 61.1% and a specificity of 76.9%.

conclusionsThis study found significantly higher levels of CK in patients with PAA than in those with NSAP. Similarly, significantly higher levels were observed in patients with complicated than in those with uncomplicated PAA. Nevertheless, the diagnostic performance of CK was only moderate in the two settings analyzed. The potential usefulness of CK determination as a tool to guide the preoperative rehydration regimen of patients with PAA to prevent postoperative hyporexia and vomiting is a promising line of research and should be evaluated in future studies.

Indexed as

AppendicitisAcute DiseaseChildHumansPilot ProjectsRetrospective StudiesROC CurveSensitivity and SpecificityAssessment toolAUCCapillaryComplicatedDehydratationDiagnosticKetone bodiesKetonemiaNon complicatedPediatric acute appendicitisROCSensitivitySpecificityYouden index

Identifiers

PMID36495332
PMCPMC9741565
OpenAlexW4311664257

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.