A novel noninvasive appendicitis score with a urine biomarker
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In brief
In brief
Prospective study of 148 children developed a novel appendicitis scoring system combining urine LRG biomarker with three clinical findings (constant pain, RIF tenderness, percussion pain). The AuB model demonstrated superior diagnostic accuracy (AUC 0.82) compared to the standard Pediatric Appendicitis Score (0.78) in distinguishing appendicitis from other causes of abdominal pain.
Written by the GCMD Library team from the article.
Purpose
The aim of our study was to develop an appendicitis score incorporating a urine biomarker, Leucine rich alpha-2-glycoprotein (LRG), for evaluation of children with abdominal pain.
Methods
From January to August 2017 we prospectively enrolled children aged 4–16 years old admitted for suspected appendicitis. Urine samples for LRG analysis were obtained preoperatively and quantified by enzyme-linked immunosorbent assay (ELISA) after correction for patient hydration status. The diagnosis of appendicitis was based on operative findings and histology. Logistic regression was used to identify prospective predictors.
Results
A total of 148 patients were recruited, of which 42(28.4%) were confirmed appendicitis. Our Appendicitis Urinary Biomarker (AuB) model incorporated urine LRG with 3 clinical predictors: ‘constant pain', ‘right iliac fossa tenderness', ‘pain on percussion'. Area under the ROC curve for AuB was 0.82 versus 0.78 for the Pediatric Appendicitis Score (PAS) on the same cohort of patients. A model-calculated risk score of