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Suspected Appendicitis – Emergency Department – Clinical Appendicitis Scores

Suspected Appendicitis Clinical Pathway – Emergency Department

Clinical Appendicitis Scores

Experienced physician's clinical impression is comparable to these scores.

Pediatric Appendicitis Risk (pARC) Calculator Variables

  • Age, sex, temperature, nausea and/or vomiting
  • Pain duration, pain location, pain with walking, pain migration, guarding
  • WBC and ANC

pARC: Pediatric Appendicitis Risk Calculator  

The Pediatric Appendicitis Score

Pediatric Appendicitis Score (PAS)
Low-Risk < 4; High-Risk ≥ 7
Nausea/vomiting 1
Anorexia 1
Migration of pain to RLQ 1
Fever 1
Cough/percussion/hopping tenderness 2
RLQ tenderness 2
Leukocytosis (WBC > 10,000) 1
Neutrophilia (ANC > 7,500) 1
Low-Risk PAS < 4 High-Risk PAS > 7 Indeterminate-Risk PAS 4–6

Low-Risk Appendicitis Score

Refined Low-Risk Appendicitis Score
Absence of maximal tenderness in RLQ
or
RLQ tenderness without pain on walking, jumping or coughing
and
ANC < 6750/mm3
NPV 95% for identifying children without appendicitis
References
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