| Objective To compare diagnostic value of modified Alvarado score,pediatric appendicitis score (PAS) and appendicitis inflammatory response score (AIR) systems combined with high frequency ultrasound (HFUS) in children with acute appendicitis (AA),and provide reference for clinical early diagnosis of AA.Methods The clinical data of 559 children with suspected AA who were treated with laparoscopic exploration in Anhui Children's Hospital from January 2019 to June 2020 were retrospectively analyzed.According to the postoperative pathological result,they were divided into AA group(n=538) and non-AA group (n=21).The modified Alvarado,PAS and AIR scoring systems were used to score each child,the receiver operating characteristic (ROC) curve was drawn,the area under the ROC curve (AUC)and the best diagnostic cut-off value of each scoring system were calculated.Lastly,the sensitivity,specificity and accuracy of each scoring system alone and in combination with HFUS for diagnosis of pediatric AA were analyzed and compared.Results The AUC of modified Alvarado,PAS and AIR scores were 0.884,0.904 and 0.808.The best diagnostic cut-off values were 7,6 and 6 points,respectively.The sensitivity and accuracy of PAS score (91.1%,90.5%)were higher than those of modified Alvarado score (83.5%,83.4%) and AIR score (82.3%,81.9%),the difference was statistically significant (P＜0.05).However,there was no statistically significant difference in specificity (P＞0.05).The sensitivity and accuracy of modified Alvarado score(98.3%,97.5%),PAS score(98.5%,97.7%) and AIR score(98.1%,97.0%) combined with HFUS were higher than those of modified Alvarado score(83.5%,83.4%),PAS score(91.1%,90.5%)and AIR score(82.3%,81.9%),the difference was statistically significant (P＜0.05),respectively.While there was no statistically significant difference in specificity(P＞0.05).Moreover,there was no statistically significant difference in sensitivity,specificity and accuracy of three combined diagnostic methods (P＞0.05).Conclusion The modified Alvarado,PAS and AIR scoring systems have certain diagnostic values for pediatric AA,while PAS has a higher diagnostic level.The diagnostic efficiency of each scoring system combined with HFUS is better than the single scoring system,which can improve sensitivity and accuracy of diagnosis of pediatric AA,which is worthy of clinical use. |
