International Journal of Clinical Pediatrics, ISSN 1927-1255 print, 1927-1263 online, Open Access
Article copyright, the authors; Journal compilation copyright, Int J Clin Pediatr and Elmer Press Inc
Journal website http://www.theijcp.org

Original Article

Volume 1, Number 1, February 2012, pages 9-18


Clinical Significance of Fever and Leukocytosis in Diagnosis of Acute Appendicitis in Children Who Visit Emergency Department With Abdominal Pain

Figures

Figure 1.
Figure 1. Flow chart of patients with appendicitis.
Figure 2.
Figure 2. ROC points and fitted AUCs for the acute appendicitis. ROC points and fitted AUCs for fever for the acute appendicitis (A), ROC points and fitted AUCs for WBC count for the acute appendicitis (B), ROC points and fitted AUCs for segment neutrophil for the acute appendicitis (C).
Figure 3.
Figure 3. ROC points and fitted AUCs for fever for the acute appendicitis. Study population with WBC count over 10,000/mm3 (A), Study population with WBC count under 10,000/mm3 (B), Study population with segment neutrophil over 75% (C), Study population with segment neutrophil under 75% (D), Study population with age range 1 - 3 years (E), Study population with age range 4 - 11 years (F), Study population with age range over 12 years (G). Among study population, acute appendicitis and mesenteric lymphadenitis (H).

Tables

Table 1. Comparison of Characteristics of Study Population
 
CharacteristicsAppendicitis group (n = 119)Non appendicitis group (n = 555)P value
*: statistical significance was established at a level of P < 0.05.
Age (years)11.5 ± 4.28.6 ± 5.3< 0.001*
Toddler (1 - 3.9 years)2 (1.7%)125 (22.5%)0.324
Child (4 - 11.9 years)58 (48.7%)238 (42.9%)0.129
Adolescent (12 - 18 years)59 (49.6%)192 (34.6%)0.210
Male sex (%)59.7%53.7%0.235
Initial temperature (°C, axillary)36.8 ± 0.636.6 ± 0.70.188
WBC count (×1000/mm3)14.8 ± 4.89.7 ± 4.1< 0.001*
Segment neutrophil (%)78.6 ± 12.464.4 ± 16.4< 0.001*

 

Table 2. Comparison of Fever and White Blood Cell Between Appendicitis and Non-Appendicitis Stratified by Age
 
CharacteristicsGroupAge group
Toddler (1 - 3.9 years)Child (4 - 11.9years)Adolescent (12 - 18 years)total
*: statistical significance was established at a level of P < 0.05.
Elevation in temperature (≥ 37.4 °C)Appendicitis0/2 (0%)11/58 (19%)3/59 (5.1%)14/119 (11.8%)
Non appendicitis27/125 (21.6%)35/238 (14.7%)14/192 (7.3%)76/555 (13.7%)
P value1.0000.4220.7690.575
Leukocytosis (≥ 10,000/mm3)Appendicitis1/2 (50.1%)53/58 (91.4%)49/59 (83.1%)103/119 (86.6%)
Non appendicitis29/51 (56.9%)57/170 (33.5%)63/177 (35.6%)149/398 (37.4%)
P value1.000< 0.001*< 0.001*< 0.001*
Shift of WBC to the left (> 75%)Appendicitis1/2 (50.0%)43/58 (74.1%)47/59 (79.7%)91/119 (76.5%)
Non appendicitis15/51 (29.4%)62/170 (36.5%)56/177 (31.6%)133/398 (33.4%)
P value0.517< 0.001*< 0.001*< 0.001*

 

Table 3. Comparison of Characteristics of Non-Appendicitis Group
 
CharacteristicsAGE group (n = 220)Fecal impaction group (n = 155)Mesenteric lymphadenitis group (n = 108)Other group (n = 72)P-value
*: statistical significance was established at a level of P < 0.05.
Age, years9.5 ± 5.56.3 ± 4.410.0 ± 4.28.5 ± 6.3< 0.001*
Male sex50.0%52.3%62.0%53.7%0.445
Initial temperature (°C, axillary)36.7 ± 0.736.6 ± 0.636.7 ± 0.736.7 ± 0.70.118
WBC count
(×1000/mm3)
9.7 ± 3.98.8 ± 3.19.6 ± 4.311.0 ± 5.0< 0.001*
Segment neutrophil (%)65.1 ± 15.859.9 ± 15.564.4 ± 17.467.7 ± 16.6< 0.001*