Using mathematical modeling in the differential diagnosis of acute abdominal syndrome in children

Abstract

The choice of the most perfect method for differential diagnosis of abdominal syndrome in children is still under discussion. It is known that primary examination and physical examination are the fastest, accessible and well-informed studies of the child’s condition.

The purpose of our work was to improve the differential diagnosis of acute appendicitis and functional disorders of the digestive tract in children with acute abdominal syndrome by determining the informativeness of clinical signs and their combination by multivariate logistic regression.

Material and methods. We have carried out a retrospective analysis of the history of illnesses of 649 children, who applied for medical aid for abdominal syndrome at MI «Odessa Regional Children’s Clinical Hospital» in the period of 2014–2016 yy. One third of children (248 persons (38.2 % (95% CI 34.4–42.0)) after the examination was diagnosed with surgical pathology.

Results. As a result of mathematical modeling, it was possible to differentiate the group membership of children with abdominal syndrome according to certain features, which made it possible to quickly and easily make a diagnosis of functional and surgical pathology of the patient’s digestive system at the stage of the primary examination with a general accuracy of 93.4% and to decide on the amount of urgent treatment (at acute appendicitis) or additional examination (at irritable bowel syndrome).

Conclusions. The proposed differential diagnosis using the multivariate logistic regression method, taking into account the integrated assessment of the combination of clinical signs, greatly speeds up the diagnosis of functional intestinal pathology, suggests the presence of syntopeia and helps to decide more quickly on the scope of additional examination and therapeutic tactics by the primary care physician.