Department of Surgery, Division of Pediatric Surgery, University of Nevada School of Medicine, Las Vegas, Nevada 89102, USA.
J Surg Res. 2010 Oct;163(2):221-4. doi: 10.1016/j.jss.2010.04.041. Epub 2010 May 21.
Delay in presentation is associated with increased perforation rates in acute appendicitis. Perforation is linked to greater morbidity, and greater risk of complications. The purpose of this study is to evaluate whether ethnicity or insurance status is associated with differences in presentation and outcomes in adult patients with acute appendicitis.
A retrospective analysis was performed for all patients 18 y of age and over with acute appendicitis between July 1, 2005 and December 31, 2008 at the only teaching hospital in the region. χ(2) and regression analyses were used to evaluate the impact of ethnicity and insurance status on perforation rates.
A total of 1003 patients with acute appendicitis were identified, of which 239 (23.8%) were perforated. Those patients with public insurance were significantly more likely to have perforated disease (P < 0.001). Additionally, those patients in the older age groups (41-64 and ≥65) were also significantly more likely (P < 0.001) to have perforated appendicitis (35.8% and 38.24%, respectively, versus 19.2% for those 18-40). The patients who presented with perforation had a greater length of stay (2.71 ± 2.14 versus 6.04 ± 3.91 d, P < 0.001).
In our population sample, ethnicity does not predict perforation rates in adult patients with acute appendicitis. Significant risks of perforation appear related to insurance status and age.
在急性阑尾炎中，就诊延迟与穿孔率增加相关。穿孔与更高的发病率和并发症风险相关。本研究旨在评估种族或保险状况是否与成年急性阑尾炎患者的就诊和结局差异相关。
对 2005 年 7 月 1 日至 2008 年 12 月 31 日期间，该地区唯一一所教学医院的所有 18 岁及以上的急性阑尾炎患者进行了回顾性分析。采用 χ(2)检验和回归分析评估种族和保险状况对穿孔率的影响。
共确定了 1003 例急性阑尾炎患者，其中 239 例（23.8%）穿孔。具有公共保险的患者发生穿孔疾病的可能性显著更高（P < 0.001）。此外，年龄较大的患者（41-64 岁和≥65 岁）也更有可能发生穿孔性阑尾炎（分别为 35.8%和 38.24%，而 18-40 岁者为 19.2%）。出现穿孔的患者的住院时间更长（2.71 ± 2.14 天与 6.04 ± 3.91 天，P < 0.001）。
在我们的人群样本中，种族并不能预测成年急性阑尾炎患者的穿孔率。穿孔的显著风险似乎与保险状况和年龄有关。
