Dickerson Theresa Ann, Bodek Ben, Diaz Laritza, Agala Chris B, Phillips Michael R, E McLean Sean, C Akinkuotu Adesola
University of North Carolina School of Medicine, Chapel Hill, NC, USA.
Gillings School of Public Health, University of North Carolina, Chapel Hill, NC, USA.
Pediatr Surg Int. 2025 Mar 6;41(1):91. doi: 10.1007/s00383-025-05989-w.
The Child Opportunity Index (COI) is a measure of neighborhood conditions associated with healthy child development. Inguinal hernia repair (IHR) is a common pediatric procedure. We sought to evaluate the association between COI and complicated inguinal hernia (IH), incarcerated or strangulated IH, among children with employer-based insurance coverage.
We performed a retrospective cohort study of children who underwent IHR in the IBM Watson Health MarketScan Research Database from 2015 to 2019. Claims data were merged with the COI at the metropolitan statistical area (MSA) level. We performed a multivariate regression analysis to determine the association between COI and complicated IH.
A total of 12,084 eligible pediatric patients were identified, of which 3.7%(n = 408) had IH. Children with complicated IH were younger than those with uncomplicated IH (2 vs. 3 years; p = 0.0016). There were no children from very low COI neighborhoods. There was no difference in COI between uncomplicated and complicated IH: (Low- 13.5% vs. 17.2%: Moderate- 67.3% vs. 63.5%; High- 19.2% vs. 19.4%; p = 0.19). Age (aOR: 0.967; 95% CI: 0.95-0.99), but not COI, was independently associated with decreased odds of complicated IH.
Neighborhood-level disadvantage, as measured by COI 2.0, was not an independent predictor of complicated IH among children with employer-based insurance coverage.
II.
儿童机会指数（COI）是衡量与儿童健康发展相关的邻里环境的指标。腹股沟疝修补术（IHR）是一种常见的儿科手术。我们试图评估在有雇主提供保险的儿童中，COI与复杂腹股沟疝（IH）、嵌顿性或绞窄性IH之间的关联。
我们对2015年至2019年在IBM Watson Health MarketScan研究数据库中接受IHR的儿童进行了一项回顾性队列研究。索赔数据与大都市统计区（MSA）层面的COI合并。我们进行了多变量回归分析，以确定COI与复杂IH之间的关联。
共确定了12,084名符合条件的儿科患者，其中3.7%（n = 408）患有IH。患有复杂IH的儿童比未患复杂IH的儿童年龄更小（2岁对3岁；p = 0.0016）。没有来自COI非常低的社区的儿童。单纯性和复杂性IH之间的COI没有差异：（低 - 13.5%对17.2%；中 - 67.3%对63.5%；高 - 19.2%对19.4%；p = 0.19）。年龄（调整后比值比：0.967；95%置信区间：0.95 - 0.99）而非COI与复杂IH的发生几率降低独立相关。
以COI 2.0衡量的邻里层面的不利因素，并不是有雇主提供保险的儿童中复杂IH的独立预测因素。
II级
