Spatial–temporal clusters of pediatric perforated appendicitis in California
Perforated appendicitis is a well-documented child health disparity. Geographic patterns in perforated appendicitis exist in several United States regions, but such patterns have not been described in California. We aimed to analyze spatial–temporal patterns of pediatric perforated appendicitis and...
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| Published in | Journal of pediatric surgery Vol. 56; no. 6; pp. 1208 - 1213 |
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| Main Authors | , |
| Format | Journal Article |
| Language | English |
| Published |
United States
Elsevier Inc
01.06.2021
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| Abstract | Perforated appendicitis is a well-documented child health disparity. Geographic patterns in perforated appendicitis exist in several United States regions, but such patterns have not been described in California. We aimed to analyze spatial–temporal patterns of pediatric perforated appendicitis and identify population characteristics contributing to these cluster patterns.
We geocoded risk-adjusted perforated appendicitis rates per 1000 appendicitis cases in patients 1–17 years from 2005–2015 in California. We performed a space-time cube analysis to identify hot spot trends. We performed logistic regression to estimate rural classification associated with spatial–temporal hot spots and multivariate analysis to assess effects of socioeconomic factors.
In 2005–2015, 43,888 cases of pediatric perforated appendicitis occurred in California. Median risk-adjusted perforated appendicitis rate was 312 per 1000 appendicitis cases. We identified 11 spatial–temporal hot spots of perforated appendicitis. Rural micropolitan counties had 14 times higher odds of being classified as a hot spot (p<0.05, 95% CI 1–185). Poverty was a significant predictor of high perforated appendicitis median risk-adjusted rate (p<0.004).
We identified 11 California hot spots of perforated appendicitis that persisted across a ten-year time span. Incorporating geography alongside our understanding of socioeconomic factors is a critical step in addressing this important child health disparity. |
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| AbstractList | BACKGROUNDPerforated appendicitis is a well-documented child health disparity. Geographic patterns in perforated appendicitis exist in several United States regions, but such patterns have not been described in California. We aimed to analyze spatial-temporal patterns of pediatric perforated appendicitis and identify population characteristics contributing to these cluster patterns. METHODSWe geocoded risk-adjusted perforated appendicitis rates per 1000 appendicitis cases in patients 1-17 years from 2005-2015 in California. We performed a space-time cube analysis to identify hot spot trends. We performed logistic regression to estimate rural classification associated with spatial-temporal hot spots and multivariate analysis to assess effects of socioeconomic factors. RESULTSIn 2005-2015, 43,888 cases of pediatric perforated appendicitis occurred in California. Median risk-adjusted perforated appendicitis rate was 312 per 1000 appendicitis cases. We identified 11 spatial-temporal hot spots of perforated appendicitis. Rural micropolitan counties had 14 times higher odds of being classified as a hot spot (p<0.05, 95% CI 1-185). Poverty was a significant predictor of high perforated appendicitis median risk-adjusted rate (p<0.004). CONCLUSIONSWe identified 11 California hot spots of perforated appendicitis that persisted across a ten-year time span. Incorporating geography alongside our understanding of socioeconomic factors is a critical step in addressing this important child health disparity. Perforated appendicitis is a well-documented child health disparity. Geographic patterns in perforated appendicitis exist in several United States regions, but such patterns have not been described in California. We aimed to analyze spatial-temporal patterns of pediatric perforated appendicitis and identify population characteristics contributing to these cluster patterns. We geocoded risk-adjusted perforated appendicitis rates per 1000 appendicitis cases in patients 1-17 years from 2005-2015 in California. We performed a space-time cube analysis to identify hot spot trends. We performed logistic regression to estimate rural classification associated with spatial-temporal hot spots and multivariate analysis to assess effects of socioeconomic factors. In 2005-2015, 43,888 cases of pediatric perforated appendicitis occurred in California. Median risk-adjusted perforated appendicitis rate was 312 per 1000 appendicitis cases. We identified 11 spatial-temporal hot spots of perforated appendicitis. Rural micropolitan counties had 14 times higher odds of being classified as a hot spot (p<0.05, 95% CI 1-185). Poverty was a significant predictor of high perforated appendicitis median risk-adjusted rate (p<0.004). We identified 11 California hot spots of perforated appendicitis that persisted across a ten-year time span. Incorporating geography alongside our understanding of socioeconomic factors is a critical step in addressing this important child health disparity. |
| Author | Schwartz, Kristy Nguyen, Margaret |
| Author_xml | – sequence: 1 givenname: Kristy orcidid: 0000-0002-7654-2178 surname: Schwartz fullname: Schwartz, Kristy email: kschwartz2@health.ucsd.edu, klputnam@health.ucsd.edu – sequence: 2 givenname: Margaret orcidid: 0000-0002-2841-0795 surname: Nguyen fullname: Nguyen, Margaret email: mbn006@health.ucsd.edu |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/33752913$$D View this record in MEDLINE/PubMed |
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| CitedBy_id | crossref_primary_10_1016_j_sempedsurg_2023_151354 crossref_primary_10_15446_revfacmed_v71n2_101309 crossref_primary_10_1016_j_surg_2022_06_053 crossref_primary_10_12677_ACM_2022_12121599 crossref_primary_10_1016_j_jpedcp_2024_200108 |
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| Keywords | GIS Spatial–temporal analysis Geographic disparity Pediatric perforated appendicitis Health disparities |
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| Snippet | Perforated appendicitis is a well-documented child health disparity. Geographic patterns in perforated appendicitis exist in several United States regions, but... BACKGROUNDPerforated appendicitis is a well-documented child health disparity. Geographic patterns in perforated appendicitis exist in several United States... |
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| SubjectTerms | Geographic disparity GIS Health disparities Pediatric perforated appendicitis Spatial–temporal analysis |
| Title | Spatial–temporal clusters of pediatric perforated appendicitis in California |
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