Benito et al reported a clinical score for evaluating children with abdominal pain. This can identify a child who has a low risk for appendicitis. The authors are from BioCruces Bizkaia Health Research Institute in Bilbao, Spain.
Name: Pediatric Appendicitis Laboratory Score (PALabS)
Patient selection: 2 to 14 years with abdominal pain
Parameters:
(1) nausea
(2) maximal pain in right lower quadrant (RLQ)
(3) WBC count per µL
(4) absolute neutrophil count per µL
(5) serum CRP in mg/dL (Cobas, Roche)
(6) plasma calprotectin in ng/mL (DS2, ALERE Healthcare)
Parameter
Finding
Points
nausea
absent
0
present
3
maximal pain RLQ
no
yes
4
WBC count
< 10,000 per µL
>= 10,000 per µL
absolute neutrophil count
< 7,500 per µL
>= 7,500 per µL
7
serum CRP
< 1 mg/dL
>= 1 mg/dL
2
plasma calprotectin
< 0.5 ng/mL
>= 0.5 ng/mL
total score =
= SUM(points for all 6 parameters)
Interpretation:
• minimum score: 0
• maximum score: 23
• A score <= 6 has a negative predictive value of 98% for acute appendicitis. A child at low risk can be managed by close observation.
Performance:
• The area under the ROC curve is 0.88.
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Specialty: Gastroenterology, Pedatrics
