Benito et al reported the Pediatric Appendicitis Laboratory Score (PALabS) for evaluating a pediatric patient for appendicitis. The authors are from Bizkaia Health Research Institute in Bilbao, Spain.
Patient selection: 2 to 14 years with suspected appendicitis
Parameters:
(1) nausea
(2) maximal pain location
(3) WBC count per µL
(4) absolute neutrophil count per µL
(5) serum CRP in mg/dL
(6) plasma calprotectin (CP) in ng/mL
Parameter
Finding
Points
nausea
absent
0
present
3
maximal pain location
RLQ
4
other
0
WBC count
< 10,000 per µL
0
>= 10,000 per µL
4
absolute neutrophil count
< 7,500 per µL
0
>= 7,500 per µL
7
serum CRP
< 1 mg/dL
0
>= 1 mg/dL
2
plasma calprotectin
< 0.5 ng/mL
0
>= 0.5 ng/mL
3
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: 0
• maximum score: 23
• A score <= 6 has a negative predictive value of 98% for acute appendicitis.
• Ultrasound can be helpful in cases where the diagnosis is uncertain.
Performance:
• The area under the ROC curve is 0.88.
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