👶 Pediatric Appendicitis Score (PAS)
Assess paediatric appendicitis likelihood with the PAS.
Clinical takeaway
≤ 3 low, 4–6 indeterminate, ≥ 7 high.
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When to use
Risk-stratify children with suspected appendicitis.
How it works
RLQ tenderness (2), cough/percussion/hop tenderness (2), and six 1-point items (anorexia, fever, nausea/vomiting, leukocytosis, neutrophilia, migration). 0–10.
Key points
- ≤ 3 low, 4–6 indeterminate, ≥ 7 high.
- Intermediate scores favour ultrasound-first imaging.
- Reduces unnecessary CT in children.
References
Decision support for licensed clinicians only; not a substitute for clinical judgement, diagnosis or local protocols.
Worked calculation
The values below come from this tool's own example placeholders and are computed server-side with the formula shown on this page, so the arithmetic can be checked quickly. It demonstrates how to substitute values only — it is not clinical advice and not a real case.
| Cough/percussion/hopping RLQ tenderness | No |
|---|---|
| RLQ tenderness | No |
| Anorexia | No |
| Fever ≥ 38°C | No |
| Nausea/vomiting | No |
| Leukocytosis ≥ 10×10⁹/L | No |
| Neutrophilia (left shift > 75%) | No |
| Migration of pain to RLQ | No |
→PAS0/10
- Interpretation：Low — appendicitis unlikely
- Note：Consider discharge with safety-netting.
| Cough/percussion/hopping RLQ tenderness | Yes (+2) |
|---|---|
| RLQ tenderness | Yes (+2) |
| Anorexia | Yes (+1) |
| Fever ≥ 38°C | Yes (+1) |
| Nausea/vomiting | Yes (+1) |
| Leukocytosis ≥ 10×10⁹/L | Yes (+1) |
| Neutrophilia (left shift > 75%) | Yes (+1) |
| Migration of pain to RLQ | Yes (+1) |
→PAS10/10
- Interpretation：High — appendicitis likely
- Note：Surgical consultation.
Frequently asked questions
- What is Pediatric Appendicitis Score (PAS)?
- Assess paediatric appendicitis likelihood with the PAS.
- How is Pediatric Appendicitis Score (PAS) calculated? What is the core formula?
- RLQ tenderness (2), cough/percussion/hop tenderness (2), and six 1-point items (anorexia, fever, nausea/vomiting, leukocytosis, neutrophilia, migration). 0–10.
- When is Pediatric Appendicitis Score (PAS) used?
- Risk-stratify children with suspected appendicitis.
- What are the key clinical points for Pediatric Appendicitis Score (PAS)?
- ≤ 3 low, 4–6 indeterminate, ≥ 7 high. Intermediate scores favour ultrasound-first imaging. Reduces unnecessary CT in children.
- What are the limits and cautions when using Pediatric Appendicitis Score (PAS)?
- For licensed clinicians and clinical researchers. Interpret results with history, investigations and local protocols; not a diagnosis or prescription, and not a substitute for multidisciplinary decision-making or local guidelines.
- How is Pediatric Appendicitis Score (PAS) calculated in practice? Can you show a worked example?
- Inputs: Cough/percussion/hopping RLQ tenderness No, RLQ tenderness No, Anorexia No, Fever ≥ 38°C No, Nausea/vomiting No, Leukocytosis ≥ 10×10⁹/L No, Neutrophilia (left shift > 75%) No, Migration of pain to RLQ No → Result: PAS 0 /10（Interpretation: Low — appendicitis unlikely, Note: Consider discharge with safety-netting.） Inputs: Cough/percussion/hopping RLQ tenderness Yes (+2), RLQ tenderness Yes (+2), Anorexia Yes (+1), Fever ≥ 38°C Yes (+1), Nausea/vomiting Yes (+1), Leukocytosis ≥ 10×10⁹/L Yes (+1), Neutrophilia (left shift > 75%) Yes (+1), Migration of pain to RLQ Yes (+1) → Result: PAS 10 /10（Interpretation: High — appendicitis likely, Note: Surgical consultation.）