Deng Yi, Chang David C, Zhang Yiyi, Webb Jennifer, Gabre-Kidan Alodia, Abdullah Fizan
Center for Pediatric Surgical Clinical Trials and Outcomes Research, Division of Pediatric Surgery, The Johns Hopkins University School of Medicine, 600 North Wolfe Street, Harvey 319, Baltimore, MD 21287-0005, USA.
Pediatr Surg Int. 2010 Jul;26(7):691-6. doi: 10.1007/s00383-010-2628-z. Epub 2010 Jun 4.
The present study aimed to determine whether children with perforated appendicitis were more likely to present during specific days of the week or seasons of the year.
After obtaining IRB exemption, a retrospective, population-based study of patients <18 with ICD9 codes of acute (540.9) or perforated (540.0, 540.1) appendicitis in the Kids' Inpatient Database (KID) was performed. Univariate and multivariate analyses were performed analyzing patient and hospital factors.
A total of 31,457 children were identified with acute appendicitis, of whom 10,524 (33.5%) were perforated. Mondays [odds ratio (OR): 1.16; 95% Confidence Interval (CI): 1.05-1.28] were significant for increased likelihood as day of presentation with perforation in US children more than any other day of the week. In seasonal analysis, fall (OR: 1.12; 95% CI: 1.04-1.21) and winter (OR: 1.11; 95% CI: 1.03-1.20) were at higher odds for perforation at presentation. Patients with Medicaid (OR: 1.22; 95% CI: 1.03-1.43) and those uninsured (OR: 1.50; 95% CI: 1.16-1.93) were more likely to present with perforation.
Perforated appendicitis was more likely to present on Mondays in US children. Although appendicitis is most common in summer months, rates of perforated appendicitis were highest in fall and winter.
本研究旨在确定患有穿孔性阑尾炎的儿童是否更有可能在一周中的特定日期或一年中的特定季节发病。
在获得机构审查委员会（IRB）豁免后，对儿童住院数据库（KID）中年龄小于18岁、国际疾病分类第九版（ICD9）代码为急性（540.9）或穿孔性（540.0、540.1）阑尾炎的患者进行了一项基于人群的回顾性研究。对患者和医院因素进行了单因素和多因素分析。
共识别出31457名患有急性阑尾炎的儿童，其中10524名（33.5%）为穿孔性阑尾炎。在美国儿童中，周一作为穿孔性阑尾炎发病日的可能性显著增加[比值比（OR）：1.16；95%置信区间（CI）：1.05 - 1.28]，高于一周中的任何其他日期。在季节分析中，秋季（OR：1.12；95%CI：1.04 - 1.21）和冬季（OR：1.11；95%CI：1.03 - 1.20）发病时穿孔的几率更高。接受医疗补助的患者（OR：1.22；95%CI：1.03 - 1.43）和未参保患者（OR：1.50；95%CI：1.16 - 1.93）更有可能出现穿孔性阑尾炎。
在美国儿童中，穿孔性阑尾炎更有可能在周一发病。虽然阑尾炎在夏季最为常见，但穿孔性阑尾炎的发病率在秋季和冬季最高。
