ArticlePediatric surgery international2025
Development and validation of a nomogram based on C-reactive protein, neutrophil count, and respiratory rate for predicting complicated appendicitis in children.
Article in Pediatric surgery international, 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
objectivesTo develop and validate a dynamic nomogram for early prediction of complicated appendicitis (CA) in children using a multi-stage feature selection strategy.
methodsA retrospective cohort of 398 pediatric patients undergoing laparoscopic appendectomy (January 2022–December 2024) was analyzed and split (7:3) into training and validation sets. Candidate predictors were screened by Boruta, LASSO, and Venn intersection, with final variables identified by multivariable logistic regression. Model performance was assessed by discrimination, calibration, and decision curve analysis.
resultsEighty-two cases (20.6%) were classified as CA. C-reactive protein (CRP), neutrophil count (NEU), and respiratory rate (RR) were retained as independent predictors. The nomogram achieved excellent discrimination (AUC 0.937, training; 0.909, validation), good calibration, and favorable clinical utility. A dynamic version is available at: https://c-xxsrjb.shinyapps.io/dynnomapp/ .
conclusionsCRP, NEU, and RR are effective predictors of pediatric CA. The proposed nomogram offers a simple, clinically practical tool for risk stratification and early decision-making.
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