Predicting the Severity of Acute Appendicitis of Young Children (<3 Years Old): Development and Assessment of a New Prediction Nomogram

Objective: There is a lack of assessment methods of acute appendicitis in little children. The purpose of this study was to develop and internally validate a nomogram for predicting the severity of acute appendicitis of young children (&lt;3 years old).Methods: We develop a prediction model base...

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Autores principales: Yang Chen, Zhiyong Wang, Dong Xiao, Hongwu Zeng, Xiaopeng Ma
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Publicado: Frontiers Media S.A. 2021
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spelling oai:doaj.org-article:da84eb91fe2045fcb0fcbb9d55d93b7e2021-11-18T07:49:49ZPredicting the Severity of Acute Appendicitis of Young Children (<3 Years Old): Development and Assessment of a New Prediction Nomogram2296-236010.3389/fped.2021.763125https://doaj.org/article/da84eb91fe2045fcb0fcbb9d55d93b7e2021-11-01T00:00:00Zhttps://www.frontiersin.org/articles/10.3389/fped.2021.763125/fullhttps://doaj.org/toc/2296-2360Objective: There is a lack of assessment methods of acute appendicitis in little children. The purpose of this study was to develop and internally validate a nomogram for predicting the severity of acute appendicitis of young children (&lt;3 years old).Methods: We develop a prediction model based on a training dataset of 121 patients (&lt;3 years old) with acute appendicitis. Admission information was collected between January 2010 and January 2021, which contained demographic characteristic, laboratory examinations, treatment and pathology type, etc. Logistic regression analysis was used to identify independent risk factors and establish the predictive model. C-index and calibration curves were applied to evaluate the performance of the nomogram. Then corrected C-index was calculated to conduct internal verification by using the bootstrapping validation. Decision curve analysis determined clinical application of the prediction model.Results: Predictors contained in the prediction nomogram included weight for age, onset time (from developing symptoms to hospital), admission temperature, leukocyte count, neutrophil ratio, and total bilirubin. Logistic regression analysis showed that weight for age (X1) &lt; -2.32 SD (P = 0.046), onset time (X2) &gt; 2.5 days (P = 0.044), admission temperature (X3) &gt; 38.5°C (P = 0.009), leukocyte count (X4) &gt; 12.185*109/L (P = 0.045), neutrophil ratio (X5) &gt; 68.7% (P = 0.029), and total bilirubin (X6) &gt; 9.05 μmol/L (P = 0.035) were found to be significant for predicting the severity of appendicitis. The logistic regression equation was logit (P) = −0.149X1 + 0.51X2 + 1.734X3 + 0.238X4 + 0.061X5 + 0.098X6 – 75.229. C-index of nomogram was calculated at 0.8948 (95% Cl: 0.8332–0.9567) and it still was 0.8867 through bootstrapping validation. Decision curve analysis showed that when the threshold probability ranged from 14 to 88%, there is a net benefit of using this prediction model for severity of appendicitis in little children.Conclusion: This novel nomogram incorporating the weight for age, onset time, admission temperature, leukocyte count, neutrophil ratio, and total bilirubin could be conveniently used to estimate the severity of appendicitis of young children &lt;3 years old) and determine appropriate treatment options in time.Yang ChenYang ChenZhiyong WangDong XiaoHongwu ZengXiaopeng MaFrontiers Media S.A.articlecomplicated appendicitisyoung childrenlaboratory examinationretrospective analysisprediction modelPediatricsRJ1-570ENFrontiers in Pediatrics, Vol 9 (2021)
institution DOAJ
collection DOAJ
language EN
topic complicated appendicitis
young children
laboratory examination
retrospective analysis
prediction model
Pediatrics
RJ1-570
spellingShingle complicated appendicitis
young children
laboratory examination
retrospective analysis
prediction model
Pediatrics
RJ1-570
Yang Chen
Yang Chen
Zhiyong Wang
Dong Xiao
Hongwu Zeng
Xiaopeng Ma
Predicting the Severity of Acute Appendicitis of Young Children (<3 Years Old): Development and Assessment of a New Prediction Nomogram
description Objective: There is a lack of assessment methods of acute appendicitis in little children. The purpose of this study was to develop and internally validate a nomogram for predicting the severity of acute appendicitis of young children (&lt;3 years old).Methods: We develop a prediction model based on a training dataset of 121 patients (&lt;3 years old) with acute appendicitis. Admission information was collected between January 2010 and January 2021, which contained demographic characteristic, laboratory examinations, treatment and pathology type, etc. Logistic regression analysis was used to identify independent risk factors and establish the predictive model. C-index and calibration curves were applied to evaluate the performance of the nomogram. Then corrected C-index was calculated to conduct internal verification by using the bootstrapping validation. Decision curve analysis determined clinical application of the prediction model.Results: Predictors contained in the prediction nomogram included weight for age, onset time (from developing symptoms to hospital), admission temperature, leukocyte count, neutrophil ratio, and total bilirubin. Logistic regression analysis showed that weight for age (X1) &lt; -2.32 SD (P = 0.046), onset time (X2) &gt; 2.5 days (P = 0.044), admission temperature (X3) &gt; 38.5°C (P = 0.009), leukocyte count (X4) &gt; 12.185*109/L (P = 0.045), neutrophil ratio (X5) &gt; 68.7% (P = 0.029), and total bilirubin (X6) &gt; 9.05 μmol/L (P = 0.035) were found to be significant for predicting the severity of appendicitis. The logistic regression equation was logit (P) = −0.149X1 + 0.51X2 + 1.734X3 + 0.238X4 + 0.061X5 + 0.098X6 – 75.229. C-index of nomogram was calculated at 0.8948 (95% Cl: 0.8332–0.9567) and it still was 0.8867 through bootstrapping validation. Decision curve analysis showed that when the threshold probability ranged from 14 to 88%, there is a net benefit of using this prediction model for severity of appendicitis in little children.Conclusion: This novel nomogram incorporating the weight for age, onset time, admission temperature, leukocyte count, neutrophil ratio, and total bilirubin could be conveniently used to estimate the severity of appendicitis of young children &lt;3 years old) and determine appropriate treatment options in time.
format article
author Yang Chen
Yang Chen
Zhiyong Wang
Dong Xiao
Hongwu Zeng
Xiaopeng Ma
author_facet Yang Chen
Yang Chen
Zhiyong Wang
Dong Xiao
Hongwu Zeng
Xiaopeng Ma
author_sort Yang Chen
title Predicting the Severity of Acute Appendicitis of Young Children (<3 Years Old): Development and Assessment of a New Prediction Nomogram
title_short Predicting the Severity of Acute Appendicitis of Young Children (<3 Years Old): Development and Assessment of a New Prediction Nomogram
title_full Predicting the Severity of Acute Appendicitis of Young Children (<3 Years Old): Development and Assessment of a New Prediction Nomogram
title_fullStr Predicting the Severity of Acute Appendicitis of Young Children (<3 Years Old): Development and Assessment of a New Prediction Nomogram
title_full_unstemmed Predicting the Severity of Acute Appendicitis of Young Children (<3 Years Old): Development and Assessment of a New Prediction Nomogram
title_sort predicting the severity of acute appendicitis of young children (<3 years old): development and assessment of a new prediction nomogram
publisher Frontiers Media S.A.
publishDate 2021
url https://doaj.org/article/da84eb91fe2045fcb0fcbb9d55d93b7e
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