CLINICAL SIGNIFICANCE OF POLYMORPHONUCLEAR NEUTROPHILS IN THE STRATIFICATION OF CHILDREN WITH ACUTE ABDOMINAL PAIN

Background. Acute abdominal pain in children is defined as acute pain of non-traumatic genesis lasting up to 5-7 days, and presents a serious diagnostic and tactical problem. Many aspects of diagnosis and treatment remain controversial. Aim. To determine the clinical significance of polymorphonuclear neutrophil count in the stratification of children with acute abdominal pain. Material and Methods. A prospective randomized blind clinical trial was performed. The results of examination and treatment of 633 children admitted to Grodno Regional Children's Clinical Hospital with acute abdominal pain were analyzed. The number of polymorphonuclear neutrophils was analyzed in relative (PNRV) and absolute (PNAV) values. Statistics included evidence-based criteria, ROC and precision-recall curve analysis, Kullback's measure of informativeness (Jxi), Bayes' theorem. Results. Separation points were determined for the PNRV and PNAV tests. It was 65% for the PNRV test and 8.952×109/L for the PNAV test. For PNRV values less than 65%, the probability of acute appendicitis (AA) as a cause of acute abdominal pain was 1.8% (CI 0.2 to 3.4); the overall informative value was 2.94. With PNAV test values less than 6.5×109/L, the probability of AA was 1.2% (CI 0.03 to 2.4%); the overall informative value was 5.24. It was demonstrated that an increase in test values above the indicated values did not significantly increase the probability of AA as a cause of acute abdominal pain in children. Conclusion. The tests studied are highly informative and can be used to stratify patients with acute abdominal pain. It is necessary to validate the results obtained taking into account the specific capabilities of a given medical institution and the type of equipment used.