Pediatric_Appendicitis_Score_guideline v.1
Pediatric Appendicitis Score (PAS) assists clinicians to predict appendicitis in children.
To assist clinicians to predict appendicitis in children.
Can be used in children or adolescents with acute abdominal pain of ≤4 days duration, especially localized to the right lower quadrant (RLQ), where appendicitis is suspected. 6 of the variables (Anorexia, Fever (temp ≥38.0ºC/100.4ºF), Nausea or vomiting, Leukocytosis (WBC ≥10,000), Neutrophilia (ANC >7,500), Migration of pain to RLQ ) are assigned 1 point if present whilst “Right lower quadrant (RLQ) tenderness to cough, percussion, or hopping” and “Tenderness over right iliac fossa” are assigned 2 points. PAS formula: Addition of the selected points. PAS stratifies patients into three risk groups (high, equivocal and low risk): Scores ≤3: “Appendicitis diagnosis unlikely” Scores 4 – 6: “Score does not rule in or out appendicitis diagnosis – consider employing imaging and/or surgical consult.” Scores ≥ 7: “Appendicitis diagnosis likely”
Not to use in patients younger than 3 years old or older than 18 years old. Can not be used in patients with known GI disease, pregnancy, or previous abdominal surgeries.
1. Samuel M. Pediatric Appendicitis Score. Journal of Pediatric Surgery, Vol 37,No 6 (June),2002: pp 877-881. 2. Goldman RD. The Paediatric Appendicitis Score (PAS) was useful in children with acute abdominal pain. Evid Based Med 2009;14:26 doi:10.1136/ebm.14.1.26 3. Kharbanda, AB. Validation and Refinement of a Prediction Rule to Identify Children at Low Risk for Acute Appendicitis. Arch Pediatr Adolesc Med 2012;166(8):738-744. doi:10.1001/archpediatrics.2012.490 4. Shah SR, Sinclair KA, Theut SB, Johnson KM, Holcomb GW 3rd, St Peter SD. Computed Tomography Utilization for the Diagnosis of Acute Appendicitis in Children Decreases With a Diagnostic Algorithm. Ann Surg. 2016 Sep;264(3):474-81. 5. Kulik DM, Uleryk EM, Maguire JL. Does this child have appendicitis? A systematic review of clinical prediction rules for children with acute abdominal pain. J Clin Epidemiol. 2013 Jan;66(1):95-104. doi: 10.1016/j.jclinepi.2012.09.004.
OBSERVATION.basic_demographic.v1, OBSERVATION.lab_test-full_blood_count.v1, OBSERVATION.body_temperature.v2, OBSERVATION.pediatric_appendicitis_score.v0
