Province-wide population survey of acute appendicitis in Canada. New twists to an old disease

Gagné, Jean Pierre; Billard, Michel; Gagnon, Robert; Laurion, M.; Jacques, Andrew

doi:10.1007/s00464-007-9227-7

Cited by 13 publications

(6 citation statements)

References 18 publications

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“…Historically, most of the surgeons performing laparoscopic appendectomies in Taiwan received laparoscopic training before the age of 40. The situation is similar in the U.S., where surgeons recertifying after 10 years performed more laparoscopic procedures compared with those recertifying after 20 or 30 years [16].…”

Section: Discussionmentioning

confidence: 90%

Outcome Comparison between Laparoscopic and Open Appendectomy: Evidence from a Nationwide Population-Based Study

Wang

et al. 2013

PLoS ONE

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BackgroundMounting evidence supports the use of laparoscopic techniques for the treatment of simple appendicitis. However, most of the advantages of these techniques are of limited clinical relevance. This study compares the treatment outcomes of laparoscopic appendectomies and open appendectomies performed in Taiwan.MethodsThis study uses data from the 2007 to 2009 Taiwan National Health Insurance Research Database. The study sample included 65,339 patients, hospitalized with a discharge diagnosis of acute appendicitis (33.8% underwent laparoscopic appendectomy). A generalized estimated equation (GEE) was performed to explore the relationship between the use of laparoscopy and 30-day re-admission. Hierarchical linear regressions were performed to examine the relationship between the use of laparoscopy, the length of stay (LOS), and the cost per discharge.ResultsA significantly lower proportion of patients undergoing laparoscopic appendectomies were re-admitted within 30 days of their index appendectomy, in comparison to patients undergoing open appendectomies (0.66% versus 1.925, p<0.001). Compared with patients undergoing open appendectomies, patients undergoing laparoscopic appendectomies had a shorter LOS (4.01 versus 5.33 days, p<0.001) and a higher cost per discharge (NT$40,554 versus NT$38,509, p<0.001. In 2007, the average exchange rate was US$1 = NT$31.0). GEE revealed that the odds ratio of 30-day readmission for patients undergoing laparoscopic appendectomy was 0.38 (95% CI = 0.33–0.46) that of patients undergoing open appendectomies, after adjusting for surgeon, hospital, and patient characteristics, as well as for the clustering effect of particular surgeons and the propensity score.ConclusionThis study found that laparoscopic appendectomies had a lower 30-day re-admission rate, and a shorter LOS, but a slightly higher cost per discharge than open appendectomies.

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Section: Discussionmentioning

confidence: 90%

Outcome Comparison between Laparoscopic and Open Appendectomy: Evidence from a Nationwide Population-Based Study

Wang

et al. 2013

PLoS ONE

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“…[18] For example, since 2000 only one population-based cohort published in North America confirmed the diagnosis of appendicitis. [20] The incidence of appendicitis, since 1990, in North America and Europe ranged from 75 to 150 per 100,000 persons. In contrast, population-based studies in North America and Europe that evaluated medical registries with confirmation of diagnosis reported that since 1990 the incidence of appendicitis ranged from 44 to 84 per 100,000.…”

Section: Discussionmentioning

confidence: 99%

Incidence of Appendicitis over Time: A Comparative Analysis of an Administrative Healthcare Database and a Pathology-Proven Appendicitis Registry

et al. 2016

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ImportanceAt the turn of the 21st century, studies evaluating the change in incidence of appendicitis over time have reported inconsistent findings.ObjectivesWe compared the differences in the incidence of appendicitis derived from a pathology registry versus an administrative database in order to validate coding in administrative databases and establish temporal trends in the incidence of appendicitis.DesignWe conducted a population-based comparative cohort study to identify all individuals with appendicitis from 2000 to2008.Setting & ParticipantsTwo population-based data sources were used to identify cases of appendicitis: 1) a pathology registry (n = 8,822); and 2) a hospital discharge abstract database (n = 10,453).Intervention & Main OutcomeThe administrative database was compared to the pathology registry for the following a priori analyses: 1) to calculate the positive predictive value (PPV) of administrative codes; 2) to compare the annual incidence of appendicitis; and 3) to assess differences in temporal trends. Temporal trends were assessed using a generalized linear model that assumed a Poisson distribution and reported as an annual percent change (APC) with 95% confidence intervals (CI). Analyses were stratified by perforated and non-perforated appendicitis.ResultsThe administrative database (PPV = 83.0%) overestimated the incidence of appendicitis (100.3 per 100,000) when compared to the pathology registry (84.2 per 100,000). Codes for perforated appendicitis were not reliable (PPV = 52.4%) leading to overestimation in the incidence of perforated appendicitis in the administrative database (34.8 per 100,000) as compared to the pathology registry (19.4 per 100,000). The incidence of appendicitis significantly increased over time in both the administrative database (APC = 2.1%; 95% CI: 1.3, 2.8) and pathology registry (APC = 4.1; 95% CI: 3.1, 5.0).Conclusion & RelevanceThe administrative database overestimated the incidence of appendicitis, particularly among perforated appendicitis. Therefore, studies utilizing administrative data to analyze perforated appendicitis should be interpreted cautiously.

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“…This is also observed in other countries. In all hospitals of the Province of Québec, Canada, the rate of appendectomy performed by laparoscopy was significantly lower in university hospitals than in non-teaching hospitals 29 . In a nationwide survey for appendectomies performed in the United States between 1997 and 2003, Van Hove et al showed that the rate of laparoscopic appendectomy was related to the socioeconomic status of patients 30 .…”

Section: Discussionmentioning

confidence: 99%

Appendectomy: comparative study between a public and a private hospital

Coelho¹,

Fernandes²,

Cortiano³

et al. 2010

Rev. Assoc. Med. Bras.

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Province-wide population survey of acute appendicitis in Canada. New twists to an old disease

Cited by 13 publications

References 18 publications

Outcome Comparison between Laparoscopic and Open Appendectomy: Evidence from a Nationwide Population-Based Study

Outcome Comparison between Laparoscopic and Open Appendectomy: Evidence from a Nationwide Population-Based Study

Incidence of Appendicitis over Time: A Comparative Analysis of an Administrative Healthcare Database and a Pathology-Proven Appendicitis Registry

Appendectomy: comparative study between a public and a private hospital

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