常见小儿外科疾病的就诊年龄：重新审视教条。

Age at presentation of common pediatric surgical conditions: Reexamining dogma.

作者信息

Aboagye Jonathan, Goldstein Seth D, Salazar Jose H, Papandria Dominic, Okoye Mekam T, Al-Omar Khaled, Stewart Dylan, Lukish Jeffrey, Abdullah Fizan

机构信息

Center for Pediatric Surgical Clinical Trials & Outcomes Research, Division of Pediatric Surgery, Johns Hopkins University School of Medicine.

出版信息

J Pediatr Surg. 2014 Jun;49(6):995-9. doi: 10.1016/j.jpedsurg.2014.01.039. Epub 2014 Feb 11.

DOI:10.1016/j.jpedsurg.2014.01.039

PMID:24888850

Abstract

PURPOSE

The commonly cited ages at presentation of many pediatric conditions have been based largely on single center or outdated epidemiologic evidence. Thus, we sought to examine the ages at presentation of common pediatric surgical conditions using cases from large national databases.

METHODS

A retrospective analysis was performed on Healthcare Cost and Utilization Project databases from 1988 to 2009. Pediatric discharges were selected using matched ICD9 diagnosis and procedure codes for malrotation, intussusception, hypertrophic pyloric stenosis (HPS), incarcerated inguinal hernia (IH), and Hirschsprung disease (HD). Descriptive statistics were computed.

RESULTS

A total of 63,750 discharges were identified, comprising 2744 cases of malrotation, 5831 of intussusception, 36,499 of HPS, 8564 of IH, and 10,112 of HD. About 58.2% of malrotation cases presented before age 1. Moreover, 92.8% of HPS presented between 3 and 10weeks. For intussusception, 50.3% and 91.4% presented prior to ages 1 and 4years, respectively. Also, 55.8% of IHD cases presented before their first birthday. For HD, 6.5% of cases presented within the neonatal period and 45.9% prior to age 1year.

CONCLUSION

Our findings support generally cited presenting ages for HPS and intussusception. However, the ages at presentation for HD, malrotation, and IH differ from commonly cited texts.

摘要

目的

许多儿科疾病的常见就诊年龄很大程度上基于单中心或过时的流行病学证据。因此，我们试图利用大型国家数据库中的病例来研究常见儿科外科疾病的就诊年龄。

方法

对1988年至2009年医疗保健成本和利用项目数据库进行回顾性分析。使用匹配的ICD9诊断和手术编码选择儿科出院病例，这些病例包括肠旋转不良、肠套叠、肥厚性幽门狭窄（HPS）、嵌顿性腹股沟疝（IH）和先天性巨结肠（HD）。计算描述性统计数据。

结果

共识别出63750例出院病例，包括2744例肠旋转不良、5831例肠套叠、36499例HPS、8564例IH和10112例HD。约58.2%的肠旋转不良病例在1岁前就诊。此外，92.8%的HPS病例在3至10周之间就诊。对于肠套叠，分别有50.3%和91.4%在1岁和4岁之前就诊。此外，55.8%的IHD病例在其第一个生日之前就诊。对于HD，6.5%的病例在新生儿期内就诊，45.9%在1岁之前就诊。