Introduction: During the past decade, nonoperative management (NOM) for simple acute appendicitis (SAA) in children has been proven safe with noninferior complications rate. The aim of this study was to examine Alvarado score and pediatric appendicitis score (PAS) together with other factors in predicting failure of NOM in children presenting with SAA.
Materials And Methods: Patients aged 5 to 18 years admitted to our department between 2017 and 2019 diagnosed with SAA were given a choice between surgical management and NOM. We divided the NOM patients into two groups: successful treatment and failed NOM, comparing their files for Alvarado score and PAS and other clinical and demographic factors, with a mean follow-up of 7 months. Failure was determined as need for appendectomy following conservative treatment due to any reason.
Results: A total of 85 patients answered criteria and chose NOM. Overall failure rate was 32.9%. We found no difference in the mean Alvarado score and PAS as well as in each component of both scores between success and failed NOM groups. However, when using the risk classification of the scores, we found a significant correlation between high-risk Alvarado score and failed NOM. After adjusting for age, gender, duration of symptoms, diagnosis of tip appendicitis, and presence of appendicolith, the odds of failure were four times higher among high-risk Alvarado group.
Conclusion: Alvarado score of 7 or higher, older age, and diagnosis of an appendicolith on imaging are possible predictors for failure of NOM for SAA in children.
Download full-text PDF |
Source |
---|---|
http://dx.doi.org/10.1055/s-0040-1718406 | DOI Listing |
Res Dev Disabil
January 2025
Institute for Community Inclusion (INICO), Spain; University of Salamanca, Spain.
Background: The number of people with intellectual and developmental disabilities (IDD) living in residential settings has not changed substantially in recent years in Spain. To change this situation the project "My House: A Life in the Community" aims to promote the transition of individuals with IDD and high support needs into community settings.
Aims: This paper deepens the understanding of the underlying mechanisms responsible for the changes observed in the process of deinstitutionalization.
Sci Rep
January 2025
Department of Gastrointestinal Surgery, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, No. 168 Litang Road, Changping District, Beijing, 102218, China.
The objective of this study was to develop a novel scoring model, assess its diagnostic value for complex appendicitis, and compare it with existing scoring systems. A total of 1,241 patients with acute appendicitis were included, comprising 868 patients in the modeling group (mean age, 35.6 ± 14.
View Article and Find Full Text PDFCancers (Basel)
December 2024
Statistical Genetics Research Group, Institute of Medical Biometry, Heidelberg University, Im Neuenheimer Feld 130.3, 69120 Heidelberg, Germany.
Latin Americans have a rich genetic make-up that translates into heterogeneous fractions of the autosomal genome in runs of homozygosity (F) and heterogeneous types and proportions of indigenous American ancestry. While autozygosity has been linked to several human diseases, very little is known about the relationship between inbreeding, genetic ancestry, and cancer risk in Latin Americans. Chile has one of the highest incidences of gallbladder cancer (GBC) in the world, and we investigated the association between inbreeding, GBC, gallstone disease (GSD), and body mass index (BMI) in 4029 genetically admixed Chileans.
View Article and Find Full Text PDFWorld J Emerg Surg
December 2024
Diagnostic Image Analysis Group, Department of Medical Imaging, Radboud University Medical Center, Nijmegen, the Netherlands.
Background: Acute abdominal pain (AAP) constitutes 5-10% of all emergency department (ED) visits, with appendicitis being a prevalent AAP etiology often necessitating surgical intervention. The variability in AAP symptoms and causes, combined with the challenge of identifying appendicitis, complicate timely intervention. To estimate the risk of appendicitis, scoring systems such as the Alvarado score have been developed.
View Article and Find Full Text PDFJ Clin Ultrasound
December 2024
Department of General Surgery, University of Health Sciences, Van Training and Research Hospital, Van, Turkey.
Background: Ultrasonography (USG), which is used as the first step in the diagnosis of acute appendicitis (AA), sometimes cannot visualize the appendix. The aim of this study was to retrospectively analyze the clinical, imaging, and pathology results of these cases and to provide information to clinicians about the next step to be taken.
Methods: The study was performed retrospectively between January 1, 2021 and December 31, 2021.
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!