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 

机构地区：[1]Pediatric Surgery Department,Hospital Universitario de Navarra,Irunlarrea 3,31008,Pamplona,Spain [2]Clinical Analysis Department,Hospital Universitario de Navarra,Pamplona,Spain [3]Pathology Department,Hospital Universitario de Navarra,Pamplona,Spain [4]Cardiovascular Translational Research,NavarraBiomed(Miguel Servet Foundation),Hospital Universitario de Navarra,Universidad Pública de Navarra(UPNA),IdiSNA,Pamplona,Spain [5]School of Medicine,Department of Preventive Medicine and Public Health,University of Navarra,Pamplona,Spain [6]CIBER Fisiopatología de la Obesidad y Nutrición(CIBERobn),Health Institute Carlos III,Madrid,Spain [7]Instituto de Investigación Sanitaria de Navarra,IdiSNA,Pamplona,Navarra,Spain

出　　处：《World Journal of Pediatrics》2022年第12期810-817,共8页世界儿科杂志（英文版）

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.

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 scarce.Methods We designed a prospective observational study to validate serum IL-6 as a marker for diagnostic classification between complicated and uncomplicated PAA.This 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 PAA.IL-6 concentration was determined in all patients at diagnosis.Comparative statistical analysis was performed using the Mann-Whitney U test,the Fisher exact test and the Kruskall Wallis test.The area under the receiver operating characteristic curves(AUC)were calculated.Results 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(P<0.001).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(P<0.001).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 86.8.The 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%,respectively.Conclusions 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.

关 键 词：Acute APPENDICITIS COMPLICATED Diagnostic INTERLEUKIN-6 PEDIATRIC UNCOMPLICATED 

分 类 号：R726.5[医药卫生—儿科]