Does age affect the outcomes and management of pediatric appendicitis?

Lee, Steven L.; Stark, Rebecca; Yaghoubian, Arezou; Shekherdimian, Shant; Kaji, Amy H.

doi:10.1016/j.jpedsurg.2011.09.030

Cited by 57 publications

(48 citation statements)

References 9 publications

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“…This tendency did not apply for the youngest children aged 0 to 4 years who at the same time had longer hospital stays (in this age group only 71% had laparoscopic appendectomy performed in 2015). As supported by our data and data by other groups, 26,27 a higher percentage of children < 5 years of age have complicated appendicitis compared with the older age groups. This could be part of the explanation for the longer hospital stays in that group.…”

Section: Discussionsupporting

confidence: 91%

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Changes in Incidence and Management of Acute Appendicitis in Children—A Population-Based Study in the Period 2000–2015

Hansen

Kleif²,

Jakobsen

et al. 2020

Eur J Pediatr Surg

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Introduction Recent studies suggest that the epidemiology and management of appendicitis have changed during the last decades. The purpose of this population-based study was to examine this in the pediatric population in Denmark. Materials and Methods Data were retrieved from the Danish National Patient Registry, the Danish Civil Registration System, and the Statbank Denmark. Patients aged 0 to 17 years diagnosed with appendicitis and appendectomized during the period 2000 to 2015 were included. The primary outcome was the annual incidences of appendicitis. Secondary outcomes were the annual percent of patients with appendicitis having a laparoscopic appendectomy, delay from admission to surgery, length of postoperative hospital stay, and 30-day postoperative mortality. Results A total of 24,046 pediatric cases of appendicitis were identified. The annual incidence steadily declined until 2008 (–29%, all ages) and then remained stable. The surgical approach of choice changed from being open appendectomy in 2000 (97%) to laparoscopic appendectomy in 2015 (94%). Simultaneously, the duration of postoperative hospital stay declined from 41 hours (median) to 17 hours. Delay from admission until surgery did not change during the period. Only one child died within the 30-day postoperative period. Conclusion In accordance with other recent studies from Western countries, we found significant changes in the incidence of acute appendicitis including a decline in all age groups except those below 5 years of age, a shift toward laparoscopic appendectomy, and decreasing time spent in the hospital during the years 2000 to 2015.

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Section: Discussionsupporting

confidence: 91%

“…This could be part of the explanation for the longer hospital stays in that group. One could also argue, as Lee et al, 27 that young children are less able to describe symptoms and therefore it is more difficult to ascertain their condition pre-and postoperatively, thus leading to longer hospitalizations.…”

Section: Discussionmentioning

confidence: 99%

Changes in Incidence and Management of Acute Appendicitis in Children—A Population-Based Study in the Period 2000–2015

Hansen

Kleif²,

Jakobsen

et al. 2020

Eur J Pediatr Surg

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“…However, that does not impact patients who are hospitalised and treated with intravenous hydration and antibiotics [15,16]. In developed countries 15% to 30% of appendicitis cases are complicated [17,18]. In contrast, among developing countries, that number rises to 60% with a mortality rate of 1%.…”

Section: Discussionmentioning

confidence: 99%

Incidence of complicated acute appendicitis: a single-centre retrospective study

Piotrowska¹,

Osman²,

Wolak³

2017

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Introduction: Abdominal pain has been one of the most common reasons patients seek medical care for centuries. Nowadays, together with laboratory diagnostics and imaging, we are able to make an early diagnosis. This leads to the introduction of early adequate treatment. Aim of the research: To analyse the incidence and causes of complicated acute appendicitis in one medical centre in between 2004 and 2016. Material and methods: A retrospective study covered the period from December 23, 2004 to November 07, 2016. It included 2048 cases of children between 0 and 18 years of age undergoing surgery for suspected acute appendicitis. Demographic and clinical characteristics as well as length of hospitalisation, antibiotics schemes, and intraoperative diagnosis were reviewed. Complicated acute appendicitis cases were distinguished and compared with the incidence in world literature. Results: The percentage of complicated acute appendicitis ranged from 39% to 60%. Complicated acute appendicitis occurs much more often in children under 5 years of age. Conclusions: The delay and failure in diagnosis of acute appendicitis results in higher incidence of complicated acute appendicitis; consequently, there are higher costs of treatment. Improving the awareness of parents and primary care physicians may allow faster diagnosis and treatment of acute appendicitis. It was noted that the reform of the National Emergency Medical Services in Poland contributed to a reduction in the incidence of complicated appendicitis.

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“…15 Lee et al found that younger children (≤5 years) were more likely to have perforated appendicitis (51%), be readmitted (7.8%), and have longer LOS (median, 4 days). 16 We showed that LOS was longer in the PS group compared with the GS group (4 vs 3 days). Although a previous study found 8 the present finding is in agreement with most previous studies comparing outcomes in pediatric appendicitis.…”

Section: Discussionmentioning

confidence: 67%

“…Lee et al . found that younger children (≤5 years) were more likely to have perforated appendicitis (51%), be readmitted (7.8%), and have longer LOS (median, 4 days) …”

Section: Discussionmentioning

confidence: 99%

Pediatric surgeon vs general surgeon: Does subspecialty training affect the outcome of appendicitis?

Silva

Aguiar

Waisberg

2014

Pediatrics International

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Does age affect the outcomes and management of pediatric appendicitis?

Cited by 57 publications

References 9 publications

Changes in Incidence and Management of Acute Appendicitis in Children—A Population-Based Study in the Period 2000–2015

Changes in Incidence and Management of Acute Appendicitis in Children—A Population-Based Study in the Period 2000–2015

Incidence of complicated acute appendicitis: a single-centre retrospective study

Pediatric surgeon vs general surgeon: Does subspecialty training affect the outcome of appendicitis?

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