The Sarah-May M L, van Amstel Paul, Noordzij Sophie M, Bakx Roel, Bijlsma Taco S, Derikx Joep P M, van Heurn L W Ernest, van der Kuip Martijn, Gorter Ramon R
Department of Pediatric Surgery, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam & Vrije Universiteit Amsterdam, 1105 AZ Amsterdam, The Netherlands.
Amsterdam Reproduction and Development Research Institute, 1081 HV Amsterdam, The Netherlands.
Children (Basel). 2023 Dec 11;10(12):1912. doi: 10.3390/children10121912.
The aim of this study was to evaluate the annual, seasonal and monthly trends in children with simple and complex appendicitis and their correlation to common viral pathogens in the Netherlands. A consecutive multicenter retrospective cohort study was performed between 2010 and 2019 including children (<18 years) surgically treated for appendicitis. The primary outcome was the distribution of children with simple and complex appendicitis per year, season and month. Relevant seasonal variation was defined as ≥5%. The secondary outcome was a positive correlation of the number of patients with simple and complex appendicitis to common viral pathogens (data anonymously provided by the Dutch Working Group on Clinical Virology from the Dutch Society for Clinical Microbiology (NVMM)). In total, 896 patients were included: N = 524 (58%) patients with simple and N = 372 (42%) with complex appendicitis. Of the children aged 0-5 years, 81% had complex appendicitis, versus 38% in 6-18 years ( < 0.001). An overall decline was demonstrated for both simple and complex appendicitis between 2010 and 2019. No seasonal variation was found for simple appendicitis. For complex appendicitis, the highest number of patients was found in spring, and lowest in summer (N = 372, spring 28.2 ± 5.1% versus summer 21.0 ± 5.8%, = 0.011), but the variance was regarded as not relevant (<5% from baseline). A positive correlation was found between complex appendicitis with Adenovirus 40.41 (R = 0.356, 95%CI 0.045-0.604, = 0.026) and simple appendicitis with Adenovirus NON 40.41 (R = 0.332, 95%CI 0.019-0.586, = 0.039), but these correlations did not remain significant after a Bonferroni correction ( < 0.003). In conclusion, we found no relevant seasonal variation for simple or complex appendicitis, nor positive correlation with common viral pathogens.
本研究的目的是评估荷兰单纯性和复杂性阑尾炎患儿的年度、季节和月度趋势，以及它们与常见病毒病原体的相关性。在2010年至2019年期间进行了一项连续性多中心回顾性队列研究，纳入接受阑尾炎手术治疗的儿童（<18岁）。主要结局是每年、每季节和每月单纯性和复杂性阑尾炎患儿的分布情况。相关季节变化定义为≥5%。次要结局是单纯性和复杂性阑尾炎患者数量与常见病毒病原体的正相关性（数据由荷兰临床微生物学会（NVMM）荷兰临床病毒学工作组匿名提供）。总共纳入了896例患者：N = 524例（58%）为单纯性阑尾炎患者，N = 372例（42%）为复杂性阑尾炎患者。在0至5岁的儿童中，81%患有复杂性阑尾炎，而在6至18岁的儿童中这一比例为38%（<0.001）。2010年至2019年期间，单纯性和复杂性阑尾炎的发病率总体呈下降趋势。未发现单纯性阑尾炎有季节性变化。对于复杂性阑尾炎，春季患者数量最多，夏季最少（N = 372例，春季28.2±5.1%，夏季21.0±5.8%，P = 0.011），但差异被认为不具有相关性（与基线相比<5%）。发现复杂性阑尾炎与腺病毒40.41呈正相关（R = 0.356，95%CI 0.045 - 0.604，P = 0.026），单纯性阑尾炎与非40.41型腺病毒呈正相关（R = 0.332，95%CI 0.019 - 0.586，P = 0.039），但在进行Bonferroni校正后，这些相关性不再显著（P < 0.003）。总之，我们发现单纯性或复杂性阑尾炎均无相关季节性变化，也未发现与常见病毒病原体的正相关性。
