Discriminatory capacity of serum interleukin-6 between complicated and uncomplicated acute appendicitis in children:a prospective validation study

作     者：Javier Arredondo Montero Giuseppa Antona Adriana Rivero Marcotegui Carlos BardajíPascual Mónica Bronte Anaut Raquel Ros Briones Amaya Fernández-Celis Natalia López-Andrés Nerea Martín-Calvo Javier Arredondo Montero;Giuseppa Antona;Adriana Rivero Marcotegui;Carlos Bardají Pascual;Mónica Bronte Anaut;Raquel Ros Briones;Amaya Fernández-Celis;Natalia López-Andrés;Nerea Martín-Calvo

作者机构：Pediatric Surgery DepartmentHospital Universitario de NavarraIrunlarrea 331008PamplonaSpain Clinical Analysis DepartmentHospital Universitario de NavarraPamplonaSpain Pathology DepartmentHospital Universitario de NavarraPamplonaSpain Cardiovascular Translational ResearchNavarraBiomed(Miguel Servet Foundation)Hospital Universitario de NavarraUniversidad Pública de Navarra(UPNA)IdiSNAPamplonaSpain School of MedicineDepartment of Preventive Medicine and Public HealthUniversity of NavarraPamplonaSpain CIBER Fisiopatología de la Obesidad y Nutrición(CIBERobn)Health Institute Carlos IIIMadridSpain Instituto de Investigación Sanitaria de NavarraIdiSNAPamplonaNavarraSpain 

出 版 物：《World Journal of Pediatrics》 (世界儿科杂志（英文版）)

年 卷 期：2022年第18卷第12期

页      面：810-817页

核心收录：

学科分类：1002[医学-临床医学] 100202[医学-儿科学] 10[医学] 

基　　金：Open Access funding provided thanks to the CRUE-CSIC agreement with Springer Nature.This study has not received external funding.None of the authors have financial disclosures to declare 

主　　题：Acute Appendicitis Complicated Diagnostic Interleukin-6 Pediatric Uncomplicated 

摘      要：Background Serum interleukin-6(IL-6)has a moderate diagnostic performance in pediatric acute appendicitis(PAA).The evidence regarding its capacity to discern between complicated and uncomplicated PAA is *** We designed a prospective observational study to validate serum IL-6 as a marker for diagnostic classification between complicated and uncomplicated *** study included 205 patients divided into three groups:(1)patients who underwent major outpatient surgery(n=57);(2)patients with non-surgical abdominal pain(NSAP)in whom the diagnosis of PAA was excluded(n=53),and(3)patients with a confirmed diagnosis of PAA(n=95).The PAA patients were further classified as uncomplicated or complicated ***-6 concentration was determined in all patients at *** statistical analysis was performed using the Mann-Whitney U test,the Fisher exact test and the Kruskall Wallis *** area under the receiver operating characteristic curves(AUC)were *** Median(interquartile range,IQR)serum IL-6 values were 2 pg/mL(2.0–3.4)in group 1,3.9 pg/mL(2.4–11.9)in group 2,and 23.9 pg/mL(11.1–61.0)in group 3(P0.001).Among the participants in group 3,those with uncomplicated PAA had median(IQR)serum IL-6 values of 17.2 pg/mL(8.5–36.8),and those with complicated PAA had 60.25 pg/mL(27.1–169)serum IL-6(P0.001).At the cut-off point of 19.55 pg/mL,the AUC for the discrimination between patients in group 2 vs.3 was 0.83[95%confidence interval(CI)0.76–0.90],with a sensitivity of 61.3%and a specificity of *** AUC for the discrimination between patients with uncomplicated and complicated PAA was 0.77(95%CI 0.68–0.86)and the cut-off point was 25.90 pg/mL,with a sensitivity and specificity of 84.6%and 65.6%,*** Serum IL-6 has a good performance in discerning between complicated and uncomplicated PAA.A score including clinical and radiological variables may increase the diagnostic performance of this molecule.