# Predictive Factors of Acute Appendicitis and Its Outcomes Among the Pediatric Age Group

## TL;DR

This study identifies factors that predict acute appendicitis and its outcomes in children under 14 years old, emphasizing the importance of clinical signs in diagnosis.

## Contribution

The study provides predictive factors for complicated appendicitis and hospital stay duration in pediatric patients.

## Key findings

- Children under five with complicated appendicitis had significantly higher appendicitis scores.
- Conservative treatment failed in 30.5% of cases.
- Simple appendicitis was more common than complicated cases in the studied population.

## Abstract

Background

Acute appendicitis in preschool children remains a diagnostic challenge despite advanced imaging techniques’ widespread availability. The majority of these children come late, often with complications such as appendicular perforation, abscess development, and peritonitis. As a consequence, hospital stays are lengthy and linked with an increase in morbidity and mortality. In this research, we aim to predict the factors of acute appendicitis and its outcomes among the pediatric age group.

Methods

We conducted a retrospective study at the Maternity and Children’s Hospital, Al Ahsa, Saudi Arabia, from 2022 to 2023 by reviewing the medical records of pediatric patients younger than 14 years admitted to the ER with acute appendicitis. We divided the patients into either complicated or simple appendicitis. We compared the two groups in terms of baseline characteristics, symptoms, and signs by using the Pediatric Appendicitis Score, duration of symptoms, and length of hospital stay as factors, and we assessed the significant predictive factors for the diagnosis of the type of appendicitis and length of hospital stay.

Results

During the study period, 246 children with a mean age of 10.1 ± 2.2 years and a male predominance of 171 (69.5%) presented with appendicitis. Simple appendicitis affected half of the participants (137, 55.7%) compared to complicated (76, 30.9%). Thirty-three children (13.4%) had a normal appendix. Complex appendicitis affected 76 (30.9%) of cases. Of those who received conservative treatment, 105 (42.7%) had a failure rate of 32 (30.5%). The mean hospital stay was 5.5 ± 4.0 days. Children under five years with complicated appendicitis had high appendicitis scores (p = < 0.05).

Conclusion

The predictive factors for pediatric appendicitis diagnosis are helpful in identifying those children who require intervention. However, the most crucial diagnostic instruments for determining the diagnosis of appendicitis in children are still the clinical signs and a physical abdominal examination.