SynthesisPediatric surgery international2025
A systematic review of risk stratification for pediatric appendicitis.
Synthesis 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 2 papers.
What it found
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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.
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.
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Who cites it
2 citing papers in PubMed.
- Inter-Rater Reliability Of Assigning A Pediatric Appendicitis Grade: An International Multicenter Study By The Canadian Consortium For Research In Pediatric Surgery (CanCORPS).Annals of surgery open : perspectives of surgical history, education, and clinical approaches · 2026Article
- Diagnostic Performance of Interleukin-6 (IL-6) and Membrane Glycoprotein Cluster of Differentiation-64 (CD64) for Acute Appendicitis in Girls Presenting with Lower Abdominal Pain.Diagnostics (Basel, Switzerland) · 2026Article
Corrections and comments
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeDisease risk stratification is essential for clinical decision-making, prognostication, and outcomes reporting. Pediatric appendicitis is typically described and treated as a binary entity of simple versus perforated, ignoring the wide variation in its presentation and outcomes. We performed a systematic review to assess and synthesize the available literature on risk stratification for pediatric appendicitis.
methodsFrom inception to July, 2024, a comprehensive search of ten databases was conducted without language restrictions. We included any study that stratified pediatric appendicitis into three or more risk groups based on outcomes, using clinical, laboratory, imaging, surgical, or histopathologic criteria, or any combination of the five. Two independent reviewers performed the initial screening, with conflicts adjudicated by two additional reviewers. The study adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.
resultsOf 4,332 studies screened, 64 were selected for full-text evaluation, and seven met the inclusion criteria. The only prospective cohort study utilized a pediatric perforated appendicitis grade assigned at operation. Of the 6 retrospective studies, two employed the American Association for the Surgery of Trauma (AAST) classification, one described a surgeon-reported categorization, one used a pathology-defined appendicitis severity scale, and two multicenter studies used a set of binary (present or absent) findings. In all studies, increased postoperative infectious complications and hospital stays were seen in the higher-risk categories.
conclusionsFew pediatric appendicitis studies report risk-stratified outcomes with no widely accepted or utilized risk stratification system. A universal pediatric appendicitis grade is needed to improve clinical care, prognostication, benchmarking, outcomes reporting, and resource allocation.
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Registered trials
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