Totapally Abhinav, Martinez Paul, Raszynski Andre, Alkhoury Fuad, Totapally Balagangadhar R
Texas Children's Hospital, Baylor College of Medicine, Houston, TX, USA.
Division of Critical Care Medicine, Nicklaus Children's Hospital, Miami, FL 33155, USA.
Surg Res Pract. 2020 Jun 29;2020:3268567. doi: 10.1155/2020/3268567. eCollection 2020.
Appendicitis continues to be one of the most common surgical conditions in the pediatric population. We set out to determine demographic and practice variations among children admitted with appendicitis and highlight the racial/ethnic and healthcare access role in relation to the rate of complicated appendicitis using the 2012 Kids' Inpatient Database (KID). . A retrospective cross-sectional database study was performed using the 2012 KID. All children (age 1 months to 20 years) with appendicitis were identified using the ICD-9 diagnosis codes. Children with a diagnosis of appendicitis were compared with all other discharges. Among children with appendicitis, demographic and practice variations and the rate of complicated appendicitis were evaluated. Univariate and multivariate analyses were done to analyze the data. Sample weighing was done to present national estimates.
In 2012, a total of 89, 935 out of 2.7 million pediatric hospital discharges (3.3%) had a diagnosis of appendicitis. The incidence of appendicitis was higher in males (4.7%), 6-15-year age group (7.43%), Hispanics (5.2%), and in the Western region (5.2%) and was lower in infants (0.02%) and African American children (1.2%) ( < 0.0001). The proportion of children with peritonitis or abscess was higher in children's hospitals (48.2% vs. 29.0%; OR 2.3, 95% CI: 2.2-2.4). The risk of complicated appendicitis was inversely related to age, while racial and ethnic minority status, bottom quartile of the income group, and government insurance increased the risk. Laparoscopic appendectomy was performed more frequently at children's hospitals (84.8% vs. 74.3%; < 0.0001).
Appendicitis is more common in Hispanics, males, older children, and in the Western region. Complicated appendicitis is more common in younger children, minority groups, low-income group, and children with government insurance. Children's hospitals manage more children with complicated appendicitis and are more likely to perform laparoscopic appendectomy.
阑尾炎仍是儿科人群中最常见的外科病症之一。我们旨在确定阑尾炎患儿的人口统计学和医疗实践差异，并利用2012年儿童住院数据库（KID）突出种族/民族及医疗服务可及性在复杂性阑尾炎发生率方面所起的作用。使用2012年KID进行了一项回顾性横断面数据库研究。通过国际疾病分类第九版（ICD - 9）诊断编码识别出所有患有阑尾炎的儿童（年龄1个月至20岁）。将诊断为阑尾炎的儿童与所有其他出院患儿进行比较。对患有阑尾炎的儿童，评估其人口统计学和医疗实践差异以及复杂性阑尾炎的发生率。进行单因素和多因素分析以分析数据。进行样本加权以呈现全国估计值。
2012年，在270万例儿科医院出院病例中，共有89935例（3.3%）诊断为阑尾炎。阑尾炎发病率在男性（4.7%）、6 - 15岁年龄组（7.43%）、西班牙裔（5.2%）以及西部地区（5.2%）较高，而在婴儿（0.02%）和非裔美国儿童（1.2%）中较低（P < 0.0001）。儿童医院中患有腹膜炎或脓肿的儿童比例较高（48.2%对29.0%；比值比2.3，95%置信区间：2.2 - 2.4）。复杂性阑尾炎的风险与年龄呈负相关，而种族和少数民族身份、收入组的最低四分位数以及政府保险会增加风险。儿童医院更频繁地进行腹腔镜阑尾切除术（84.8%对74.3%；P < 0.0001）。
阑尾炎在西班牙裔、男性、大龄儿童以及西部地区更为常见。复杂性阑尾炎在年幼儿童、少数群体、低收入群体以及有政府保险的儿童中更为常见。儿童医院诊治更多患有复杂性阑尾炎的儿童，并且更有可能进行腹腔镜阑尾切除术。
