Predicting the Severity of Acute Appendicitis of Young Children (<3 Years Old): Development and Assessment of a New Prediction Nomogram

Objective: There is a lack of assessment methods of acute appendicitis in little children. The purpose of this study was to develop and internally validate a nomogram for predicting the severity of acute appendicitis of young children ( 38.5°C ( P = 0.009), leukocyte count (X4) > 12.185 * 109/L ( P = 0.045), neutrophil ratio (X5) > 68.7% ( P = 0.029), and total bilirubin (X6) > 9.05 μmol/L ( P = 0.035) were found to be significant for predicting the severity of appendicitis. The logistic regression equation was logit ( P ) = −0.149X1 + 0.51X2 + 1.734X3 + 0.238X4 + 0.061X5 + 0.098X6 – 75.229. C-index of nomogram was calculated at 0.8948 (95% Cl: 0.8332–0.9567) and it still was 0.8867 through bootstrapping validation. Decision curve analysis showed that when the threshold probability ranged from 14 to 88%, there is a net benefit of using this prediction model for severity of appendicitis in little children. Conclusion: This novel nomogram incorporating the weight for age, onset time, admission temperature, leukocyte count, neutrophil ratio, and total bilirubin could be conveniently used to estimate the severity of appendicitis of young children