The effect of race on outcomes for appendicitis in children: a nationwide analysis

• Published in: The American journal of surgery Vol. 207; no. 5; pp. 748 - 753
• Main Authors: Zwintscher, Nathan P., M.D, Steele, Scott R., M.D, Martin, Matthew J., M.D, Newton, Christopher R., M.D
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.05.2014; Elsevier Limited
• Subjects: Acute Disease; Adolescent; African Americans; Age; Appendectomy - methods; Appendicitis; Appendicitis - ethnology; Appendicitis - surgery; Asian Americans; Child; Child, Preschool; Children & youth; Confidence intervals; Databases, Factual; Ethnicity; European Continental Ancestry Group; Family income; Female; Health care access; Healthcare Disparities - ethnology; Healthcare disparity; Hernias; Hispanic Americans; Hospitalization; Humans; Indians, North American; Infant; Infant, Newborn; Laparoscopy; Length of Stay; Logistic Models; Logistics; Male; Mortality; Odds Ratio; Outcomes; Perforation; Postoperative Complications - ethnology; Race; Regression analysis; Socioeconomic factors; Surgery; Treatment Outcome; United States; Variance analysis; Young Adult; United States; Laparoscopy; Appendicitis; Perforation; Outcomes; Healthcare disparity; Race
• ISSN: 0002-9610; 1879-1883
• DOI: 10.1016/j.amjsurg.2013.12.020

Abstract Background We sought to examine the impact of race on the management and outcomes of appendicitis in children aged 20 years or younger. Methods We studied 96,865 inpatient admissions for children undergoing an appendectomy for acute appendicitis in 2009 using the Kids' Inpatient Database. Results Perforation at presentation was more common among African-Americans and Hispanics than Caucasians (27.5% and 32.5%, respectively, vs 23.9%, P  < .001). African-Americans were less likely to have a laparoscopic procedure (odds ratio [OR]: .839, P  < .001) and more likely to experience a complication (OR: 1.753, P  < .001). Hispanics were also more likely to have a complication (OR: 1.123, P  = .001). African-Americans and Hispanics remained in the hospital for .73 more days than Caucasians (3.07 vs 2.34 days, P  < .001). Conclusions African-American and Hispanic children present more often with perforation. Adjusting for perforation, they were more likely to have a complication and longer hospital stays. Access to care and delayed presentations may be potential explanations.