Determining clinical predictors to identify non‐specific abdominal pain and the added value of laboratory examinations: A prospective derivation study in a paediatric emergency department

• DOI: 10.1111/apa.16911
• Publication Date: 2023-07-18T16:29:27Z
• Authors: Manon Bouënel; Victoire Lefebvre; Camille Trouillet; Remy Diesnis; Guillaume Pouessel; Yasemin Karaca‐Al...
• Keywords: C-Reactive Protein; Vomiting; Humans; Prospective Studies; Child; Emergency Service, Hospital; 3. Good health; Abdominal Pain

Abstract Aim To develop a model to discriminate non‐specific abdominal pain (NSAP) from organic in the paediatric emergency department (PED) and evaluate added value of laboratory markers. Methods Prospective cohort study an urban French PED including all patients aged ≥4 years with between November 2020 May 2021. The outcome was discrimination NSAP (patients coded have only “pain” or “constipation”) (all other diagnoses) using stepwise backward multivariate logistic regression method bootstrap resampling. Results enrolled 246 patients. Overall, 163 (66.2%) had NSAP. Four variables associated pain: epigastric region (OR 0.48 [0.23–0.99]), worsening (0.57 [0.32–0.99]), migration (0.42 [0.17–0.99]) vomiting (0.47 [0.26–0.84]) were integrated clinical model. probability 65%, sensitivity 71.8% (64.9–78.7), specificity 53.0% (42.3–63.7), Net Benefit (NB) 15.4%. White Blood Count C‐reactive protein results improved discriminative capacity (AUC 0.708 [0.643–0.773] vs. 0.654 [0.585–0.723], p = 0.01) supplementary NB 12%. Patient follow‐up showed 95% diagnostic accuracy. Conclusion This reveals four‐clinical predictor 15% predicting Validation studies are necessary.