ArticleAnnals of medicine and surgery (2012)2025
Neutrophil-to-lymphocyte ratio as an adjunct to clinical scoring systems for diagnosing perforated appendicitis in children: prospective cohort study.
Article in Annals of medicine and surgery (2012), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Prompt identification of children susceptible to appendicitis is essential to ensure optimal therapeutic intervention and minimize adverse sequelae. This study assesses the efficacy of laboratory tests and clinical examination findings in diagnosing pediatric patients with perforated appendicitis. Methods: This prospective cohort study included children susceptible to appendicitis who had surgery from 2021 to 2023. Laboratory markers, the Alvarado score (AS), the pediatric appendicitis score (PAS), and the appendicitis inflammatory response (AIR) score were assessed for sensitivity, specificity, and area under the receiver operating characteristic curve (AUC) to differentiate between perforated and non-perforated appendicitis. Results: A total of 200 patients (174 with non-perforated conditions and 26 with perforated conditions) were evaluated, revealing statistically significant differences in AS between the groups ( Conclusion: The AS and PAS demonstrated limited discriminative power, whereas the AIR score performed more favorably, particularly in children under 4 years of age. The NLR showed the strongest diagnostic performance and, when applied alongside established scoring systems, may enhance accuracy in differentiating perforated from nonperforated appendicitis in pediatric patients.
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