Evidence mapPaperPMID 41897039Full record

ReviewChildren (Basel, Switzerland)2026

Nutritional Status as a Risk Factor for Appendiceal Perforation in Pediatric Acute Appendicitis: Systematic Review.

Ciprian-Ioan Borca, Cristiana-Smaranda Ivan, Corneluta Fira-Mladinescu, Roxana Margan, Madalin-Marius Margan, Alexandru Cristian Cindrea, Claudia-Raluca Balasa-Virzob, Brigitha Vlaicu, Vlad-Laurentiu David

Abstract readReview
In one paragraph

Review in Children (Basel, Switzerland), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Ciprian-Ioan BorcaDoctoral School, Victor Babes University of Medicine and Pharmacy Timisoara, E. Murgu Square, No. 2, 300041 Timisoara, Romania.
Cristiana-Smaranda IvanDoctoral School, Victor Babes University of Medicine and Pharmacy Timisoara, E. Murgu Square, No. 2, 300041 Timisoara, Romania.ORCID 0009-0001-0512-9183
Corneluta Fira-MladinescuDiscipline of Hygiene, Department of Microbiology, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania.ORCID 0009-0007-1714-6830
Roxana MarganDiscipline of Hygiene, Department of Microbiology, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania.ORCID 0000-0002-5097-858X
Madalin-Marius MarganDiscipline of Public Health, Department of Functional Sciences, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania.ORCID 0000-0003-2375-2793
Alexandru Cristian CindreaDoctoral School, Victor Babes University of Medicine and Pharmacy Timisoara, E. Murgu Square, No. 2, 300041 Timisoara, Romania.ORCID 0009-0001-7935-4471
Claudia-Raluca Balasa-VirzobDepartment of Clinic Nursing, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania.ORCID 0009-0005-3870-6986
Brigitha VlaicuDiscipline of Hygiene, Department of Microbiology, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania.
Vlad-Laurentiu DavidDepartment of Pediatric Surgery and Orthopedics, "Louis Turcanu" Emergency Children's Hospital, 300011 Timisoara, Romania.ORCID 0000-0003-4295-7487

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe association between nutritional status and perforation or complicated appendicitis in children remains uncertain.

objectiveTo review evidence on anthropometric and biochemical nutritional indicators in relation to perforation and complicated appendicitis in pediatric acute appendicitis.

methodsPubMed, Scopus, and Web of Science were searched for peer-reviewed English-language studies published from 1 January 2010 to 1 January 2026, with supplementary citation searching and Google Scholar screening. Eligible studies included participants aged 0-18 years and reported BMI-based measures and/or biochemical nutritional markers (e.g., albumin, prealbumin, or derived inflammation-nutrition indices) stratified by perforation or complicated appendicitis. Risk of bias was assessed using ROBINS-E.

resultsFourteen observational studies were included. Associations between obesity and perforation or complicated appendicitis were inconsistent, and large registry-based analyses did not identify obesity as an independent predictor after adjustment. Underweight status was more consistently associated with complicated disease and adverse clinical course. Biochemical markers and inflammation-nutrition indices showed more consistent associations with perforated or complicated appendicitis than BMI categories, with several studies reporting moderate-to-high discrimination for severe disease.

conclusionsBMI-based classifications alone did not reliably predict perforation or complicated appendicitis. Albumin- and prealbumin-based indices were more consistently associated with disease severity, but the observational evidence does not establish causality and may reflect inflammatory severity at presentation. Prospective studies with standardized definitions and marker assessment are needed to evaluate incremental prognostic value beyond symptom duration and clinical severity scores.

Indexed as

appendiceal perforationbody mass indexcomplicated appendicitisnutritional statusobesitypediatric appendicitisserum albuminunderweight

Identifiers

PMID41897039
PMCPMC13025327

What Socratic holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.