Department of Surgery, New York-Presbyterian Queens, New York, NY, United States.
Department of Surgery, New York-Presbyterian Queens, New York, NY, United States.
J Gastrointest Surg. 2024 Oct;28(10):1629-1632. doi: 10.1016/j.gassur.2024.07.022. Epub 2024 Aug 2.
Language preference is a contributing factor for prolonged time from symptom onset to appendectomy within pediatrics, but is poorly characterized in adults. We aimed to investigate associations between language barriers and delays in assessment and treatment for adults with acute appendicitis.
In a multiethnic community, patients aged ≥18 years old who underwent appendectomy were identified between January 2017 and August 2022 at a single institution. Negative binomial regression was used to compare interval wait times to imaging, medication administration, and surgical evaluation between patients with limited English proficiency and those who are English proficient.
Of the 1469 patients included, 48% (n = 699) were with limited English proficiency. Average age was higher for patients with limited English proficiency (45 vs 36, P < .001). Most of them were Asian (54%) and without private insurance (65%, P < .001). Symptom duration, incidence of septic shock, and date/time of presentation to the emergency department were similar. Patients with limited English proficiency presented more frequently with gangrenous appendicitis (20% vs 15%, P = .013) but not perforated (23% vs 20%, P = .065). They experienced longer wait times for surgical evaluation (376 vs 348 min, incidence rate ratio [IRR], 1.08; P = .002) but similar times for imaging, and medications administered. After controlling for demographics, triage acuity, and hospital factors, significantly longer wait times for surgical evaluation persisted (IRR adjusted, 1.07; P = .038). There was no significant difference in hospital length-of-stay, postoperative infection, or 30-day readmission rate.
Adult patients with limited English proficiency may experience longer wait times for surgical evaluation for acute appendicitis, but this may not result in clinically significant delays in the initiation of treatment.
语言偏好是导致儿科患者从症状出现到阑尾切除手术时间延长的一个因素，但在成人中描述不足。我们旨在研究语言障碍与急性阑尾炎成人评估和治疗延迟之间的关系。
在一个多民族社区中，在一家机构于 2017 年 1 月至 2022 年 8 月期间，确定了年龄≥18 岁接受阑尾切除术的患者。使用负二项回归比较了英语水平有限和英语水平熟练的患者之间影像学、药物治疗和手术评估的间隔等待时间。
在 1469 名患者中，48%（n=699）英语水平有限。英语水平有限的患者年龄较大（45 岁 vs. 36 岁，P<.001）。他们大多数是亚洲人（54%），没有私人保险（65%，P<.001）。症状持续时间、脓毒性休克发生率和到急诊科就诊的日期/时间相似。英语水平有限的患者更常出现坏疽性阑尾炎（20% vs. 15%，P=.013），但穿孔（23% vs. 20%，P=.065）少见。他们接受手术评估的等待时间更长（376 分钟 vs. 348 分钟，发病率比 [IRR]，1.08；P=.002），但影像学和药物治疗时间相似。在控制人口统计学、分诊 acuity 和医院因素后，手术评估的等待时间仍然更长（IRR 调整后，1.07；P=.038）。住院时间、术后感染或 30 天再入院率没有显著差异。
英语水平有限的成年患者可能需要更长的时间才能接受急性阑尾炎手术评估，但这可能不会导致治疗开始的临床显著延迟。
