Pediatric appendicitis score: A retrospective analysis

Aims: Evaluation of the pediatric appendicitis score (PAS), in all patients who had an appendicectomy over a one-year period.
Methods: Retrospective study of 56 patients aged 4-15 years, who underwent an emergency appendicectomy. PAS was applied and patients were divided according to the PAS protocol into high probability and low probability groups. These results were then correlated with histology.
Results: The PAS had sensitivity 0.87, specificity 0.59, positive predictive value 0.83, and negative predictive value 0.67. The negative appendicectomy rate would have been reduced to 17%, but five patients with appendicitis would have been denied early surgical treatment and may have been discharged.
Conclusions: The PAS cannot be recommended as it would lead to an unacceptable risk of wrongly discharging or delaying necessary surgery in 13% of patients with appendicitis.