Diagnostic performance of serum pentraxin-3 in pediatric acute appendicitis: a prospective diagnostic validation study
Introduction Pediatric acute appendicitis (PAA) is a pathology with a high rate of diagnostic error. The search for new diagnostic tools is justified by the high morbidity and healthcare costs associated with diagnostic error. Methods We designed a prospective study to validate serum pentraxin-...
| Main Authors: | , , , , , , , , |
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| Format: | info:eu-repo/semantics/article |
| Language: | eng |
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Springer
2023
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| Subjects: | |
| Online Access: | https://hdl.handle.net/10171/66115 |
| _version_ | 1793400069326635008 |
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| author | Arredondo-Montero, J. (Javier) Antona, G. (Giuseppa) Bronte-Anaut, M. (Mónica) Bardají-Pascual, C. (Carlos) Ros-Briones, R. (Raquel) Fernández-Celís, A. (Amaya) Rivero-Marcotegui, A. (Adriana) Lopez-Andres, N. (Natalia) Martin-Calvo, N. (Nerea) |
| author_facet | Arredondo-Montero, J. (Javier) Antona, G. (Giuseppa) Bronte-Anaut, M. (Mónica) Bardají-Pascual, C. (Carlos) Ros-Briones, R. (Raquel) Fernández-Celís, A. (Amaya) Rivero-Marcotegui, A. (Adriana) Lopez-Andres, N. (Natalia) Martin-Calvo, N. (Nerea) |
| author_sort | Arredondo-Montero, J. (Javier) |
| collection | DSpace |
| description | Introduction
Pediatric acute appendicitis (PAA) is a pathology with a high rate of diagnostic error. The search for new diagnostic tools is justified by the high morbidity and healthcare costs associated with diagnostic error.
Methods
We designed a prospective study to validate serum pentraxin-3 (PTX3) as a diagnostic tool in PAA. Participants were divided into three groups: (1) patients with no underlying pathology (2) patients with non-surgical abdominal pain and (3) patients with a confirmed diagnosis of PAA. For further analyses, patients in group 3 were divided into complicated or uncomplicated PAA. Quantitative variables were expressed as medians and interquartile ranges and categorical variables as percentages. Quantitative variables were compared using the Kruskal–Wallis test and the Mann–Whitney U test. Diagnostic performance was evaluated with ROC curves.
Results
This study included 215 patients divided into group 1 (n : 63), group 2 (n : 53) and group 3 (n : 99). Median serum PTX3 values were 2.54 (1.70–2.95) ng/mL, 3.29 (2.19–7.64) ng/mL and 8.94 (6.16–14.05) in groups 1, 2 and 3, respectively (p : 0.001). Patients with complicated PAA showed significantly higher values than patients with uncomplicated PAA (p = 0.04). The AUC (group 2 vs. 3) was 0.77 (95/100 CI 0.69–0.85) and the best cut-off point was at 7.28 ng/mL, with a sensitivity of 61.3/100 and a specificity of 73.1/100. The AUC (complicated vs. uncomplicated PAA) was 0.65 (95/100 CI 0.54–0.77) and the best cut-off point was 12.33 ng/mL, with a sensitivity of 51.72/100 and a specificity of 72.73/100.
Conclusions
The diagnostic ability of serum PTX3 in PAA is only moderate and therefore it cannot be considered a definitive diagnostic test. The discriminatory ability of PTX3 between complicated and uncomplicated PAA is poor. These findings, which contrast with those reported to date, should be validated with future properly designed prospective studies. |
| format | info:eu-repo/semantics/article |
| id | oai:dadun.unav.edu:10171-66115 |
| institution | Universidad de Navarra |
| language | eng |
| publishDate | 2023 |
| publisher | Springer |
| record_format | dspace |
| spelling | oai:dadun.unav.edu:10171-661152023-05-01T05:07:31Z Diagnostic performance of serum pentraxin-3 in pediatric acute appendicitis: a prospective diagnostic validation study Arredondo-Montero, J. (Javier) Antona, G. (Giuseppa) Bronte-Anaut, M. (Mónica) Bardají-Pascual, C. (Carlos) Ros-Briones, R. (Raquel) Fernández-Celís, A. (Amaya) Rivero-Marcotegui, A. (Adriana) Lopez-Andres, N. (Natalia) Martin-Calvo, N. (Nerea) PTX3 TSG14 Pediatric acute appendicitis Complicated ROC Diagnosis Introduction Pediatric acute appendicitis (PAA) is a pathology with a high rate of diagnostic error. The search for new diagnostic tools is justified by the high morbidity and healthcare costs associated with diagnostic error. Methods We designed a prospective study to validate serum pentraxin-3 (PTX3) as a diagnostic tool in PAA. Participants were divided into three groups: (1) patients with no underlying pathology (2) patients with non-surgical abdominal pain and (3) patients with a confirmed diagnosis of PAA. For further analyses, patients in group 3 were divided into complicated or uncomplicated PAA. Quantitative variables were expressed as medians and interquartile ranges and categorical variables as percentages. Quantitative variables were compared using the Kruskal–Wallis test and the Mann–Whitney U test. Diagnostic performance was evaluated with ROC curves. Results This study included 215 patients divided into group 1 (n : 63), group 2 (n : 53) and group 3 (n : 99). Median serum PTX3 values were 2.54 (1.70–2.95) ng/mL, 3.29 (2.19–7.64) ng/mL and 8.94 (6.16–14.05) in groups 1, 2 and 3, respectively (p : 0.001). Patients with complicated PAA showed significantly higher values than patients with uncomplicated PAA (p = 0.04). The AUC (group 2 vs. 3) was 0.77 (95/100 CI 0.69–0.85) and the best cut-off point was at 7.28 ng/mL, with a sensitivity of 61.3/100 and a specificity of 73.1/100. The AUC (complicated vs. uncomplicated PAA) was 0.65 (95/100 CI 0.54–0.77) and the best cut-off point was 12.33 ng/mL, with a sensitivity of 51.72/100 and a specificity of 72.73/100. Conclusions The diagnostic ability of serum PTX3 in PAA is only moderate and therefore it cannot be considered a definitive diagnostic test. The discriminatory ability of PTX3 between complicated and uncomplicated PAA is poor. These findings, which contrast with those reported to date, should be validated with future properly designed prospective studies. 2023-04-25T11:48:38Z 2023-04-25T11:48:38Z 2022 info:eu-repo/semantics/article https://hdl.handle.net/10171/66115 eng info:eu-repo/semantics/openAccess application/pdf Springer |
| spellingShingle | PTX3 TSG14 Pediatric acute appendicitis Complicated ROC Diagnosis Arredondo-Montero, J. (Javier) Antona, G. (Giuseppa) Bronte-Anaut, M. (Mónica) Bardají-Pascual, C. (Carlos) Ros-Briones, R. (Raquel) Fernández-Celís, A. (Amaya) Rivero-Marcotegui, A. (Adriana) Lopez-Andres, N. (Natalia) Martin-Calvo, N. (Nerea) Diagnostic performance of serum pentraxin-3 in pediatric acute appendicitis: a prospective diagnostic validation study |
| title | Diagnostic performance of serum pentraxin-3 in pediatric acute appendicitis: a prospective diagnostic validation study |
| title_full | Diagnostic performance of serum pentraxin-3 in pediatric acute appendicitis: a prospective diagnostic validation study |
| title_fullStr | Diagnostic performance of serum pentraxin-3 in pediatric acute appendicitis: a prospective diagnostic validation study |
| title_full_unstemmed | Diagnostic performance of serum pentraxin-3 in pediatric acute appendicitis: a prospective diagnostic validation study |
| title_short | Diagnostic performance of serum pentraxin-3 in pediatric acute appendicitis: a prospective diagnostic validation study |
| title_sort | diagnostic performance of serum pentraxin-3 in pediatric acute appendicitis: a prospective diagnostic validation study |
| topic | PTX3 TSG14 Pediatric acute appendicitis Complicated ROC Diagnosis |
| url | https://hdl.handle.net/10171/66115 |
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