Biomarcadores diagnósticos de apendicitis aguda en pacientes pediátricos, atendidos por dolor abdominal en los servicios de urgencias españoles

Résumé

Acute abdominal pain (AAP) is one of the most frequent reasons for consultation in emergency departments (ED). Acute appendicitis (AA) is one of the main differential diagnoses to take into account in children and adolescents, being the most frequent cause of urgent surgery in this age group. Despite the advances, the diagnosis remains difficult, especially in the younger ages. The usefulness of the medical history and physical examination may be less compared to the adult population since children are associated with a higher frequency of atypical clinical presentation.Various clinical-analytical scales have been published as helpful tools for the diagnostic process of patients with suspected AA, reducing the time required for diagnosis, the number of imaging tests, and inappropriate appendectomies. The Alvarado score (AS), the most used to date, combines symptoms and signs with analytical data such as leukocytosis and neutrophilia and, depending on the score, gives recommendations on discharge, observation and the need for surgical intervention. However, the precision of these scores in the pediatric population is not well evaluated. At present, lines of research are also being developed based on new biomarkers such as the APPY1 Test, which is a multi-marker approach at the bedside that could be used to rule out AA quickly and safely...