Adv Pediatr Surg.  2023 Jun;29(1):32-39. 10.13029/aps.2023.29.1.32.

I Gee Score: Scoring System for Perforated Appendicitis: Effective Usage of Health Care Resources in COVID-19 Pandemic

• LN S
• Jadhav V
• BC G

• KMID: 2551510
• DOI: http://doi.org/10.13029/aps.2023.29.1.32

Abstract

Purpose
During the coronavirus disease 2019 pandemic, with an aim to reduce the burden on the strained health care resources, operating on suspected perforated appendicitis while managing simple appendicitis conservatively was followed in our institution. The aim of this study was to determine the predictive value of clinical features and investigations for discriminating between perforated and non-perforated appendicitis in children and devise a scoring system.
Methods
A retrospective study of all consecutive children who underwent appendectomy for acute appendicitis at our institution, a tertiary care pediatric center in South India, between 1st June 2020 to 31st May 2021 (period, one year) was carried out. In line with our standard operative procedure suspected perforated appendicitis were operated while simple appendicitis were managed conservatively in our institution. Patient demographics details, clinical features and investigations data were collected, and univariate and multivariate analysis carried out.
Results
Total of 58 patients were included in the study. Longer duration of symptoms, leukocytosis, serum sodium <135 mEq/L, appendicolith and free fluid and abscess on ultrasonography are good predictors of perforated appendicitis. We have evolved a reliable scoring system to identify perforated appendicitis.
Conclusion
Accurate identification perforated appendicitis with our scoring system is possible and results in effective usage of health care resources.

Keyword

COVID-19; Acute appendicitis; Perforated appendicitis; Pediatric