ArticlePediatric surgery international2025
The predictive value of neutrophil, C-reactive protein, fibrinogen, and chloride for acute complicated appendicitis in children: a multicenter retrospective study.
Article in Pediatric surgery international, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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Who cites it
3 citing papers in PubMed.
- Integration of clinical information for identification of gangrenous or perforated appendicitis in children: a multicenter retrospective cohort study with external validation.BMC pediatrics · 2026Article
- A Simple Preoperative Scoring System for Risk Stratification of Complicated Appendicitis in Children.Children (Basel, Switzerland) · 2026Article
- Diagnostic Performance of Inflammatory Biomarkers in Pediatric Acute Appendicitis.Children (Basel, Switzerland) · 2026Article
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Authors and funding
10 authors.
Funding
Abstract
objectivesThis study aimed to develop a diagnostic model utilizing clinical and laboratory data to identify complicated appendicitis in pediatric patients, improving acute appendicitis management.
methodsRetrospective analysis of pediatric acute appendicitis cases (2018-2023) at two hospitals collected medical history, clinical criteria, and blood samples. Patients were divided into complicated and uncomplicated appendicitis groups for comparison. Significant variables were identified using the Least Absolute Shrinkage and Selection Operator (LASSO), and incorporated into a logistic regression model to construct a nomogram. The effectiveness of the model was assessed based on sensitivity, specificity, accuracy, and comparison with existing scoring systems.
resultsAmong 323 patients, four variables (neutrophil (NEU), C-reactive protein (CRP), fibrinogen (Fg), and chlorine (Cl)) were identified as significant. The recommended cutoff value of nomogram was 0.730, exceeding that of Alvarado and PAS, with higher sensitivity (81.7%), specificity (82.6%), and accuracy (82.0%), as well as better performance in both internal and external validations. Furthermore, it demonstrated excellent calibration and clinical utility.
conclusionsNEU, CRP, Fg, and Cl are effective markers for diagnosing complicated appendicitis in children. The nomogram model can be considered to be incorporated into the diagnosis process of appendicitis as an auxiliary means of surgical intervention decision-making in complex appendicitis cases.
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