Association of meteorological factors with pediatric acute appendicitis in China

Abstract

Acute appendicitis (AA) affects between 7% and 8% of the world population and is one of the most common general surgical emergencies. The concept of seasonal patterns in the incidence of AA remains controversial. Thus, this study aimed to investigate whether meteorological factors are related to variations in the rate of pediatric AA cases at the Children's Hospital in Chongqing, China.In total, in this retrospective survey, 3436 children younger than 18 years who had been hospitalized with AA from January 1, 2008 to December 31, 2013 were enrolled, and the meteorological factors during this period were collected.Patients with AA showed a male/female ratio of 1.81:1; the highest incidence age ranged from 6 to 12 years old (P < .0001). The highest incidences of pediatric AA occurred in summer and autumn, with a peak in September and a trough in February. Pearson correlation analysis showed that the monthly mean temperature (r = 0.357, P = .001), monthly mean relative humidity (r = −0.357, P = .001), and monthly mean sunshine duration (r = 0.235, P = −0.031) were relatively weak correlated with pediatric AA. Multiple linear regression analysis indicated that pediatric AA occurrence was positively affected by monthly mean temperature (P < .0001) and negatively affected by monthly mean humidity (P < .0001) and monthly sum of sunshine (P < .0001), while monthly mean air pressure (P = .092), monthly wind speed (P = .143) and monthly precipitation (P = .297) were marginally associated with pediatric AA.Pediatric AA is associated with climatic factors. Specifically, pediatric AA is more likely related to the following meteorological conditions of: high temperature (20 °C–30 °C), low humidity, and less sunshine.

Seasonal Variation in Cases of Acute Appendicitis

“…Moreover, our data suggested a moderate positive correlation between the mean temperature and incidence. Our findings are in line with other studies which addressed this issue in Canada, the United States, South Korea, Iran, Italy, Taiwan, Pakistan, Finland, China, and the United Kingdom [3,5,[8][9][10][11][12][13].…”

“…This was attributed to lymphoid hyperplasia which may be associated with the outbreak of enterovirus during this time of the year [ 9 ]. Zhang et al proposed that pediatric appendicitis cases were associated with higher temperatures, lower humidity, and less sunshine [ 12 ].…”

Evaluation of the diagnostic value of platelet indices in pediatric acute appendicitis

“…Studies on pediatric AA have shown that the mean age of AA cases is approximately 10 to 12 years and it is more common in boys. 9 , 13 – 15 Our findings regarding age and sex distribution are consistent with the literature. 9 , 13 – 15 However, according to surgical and histopathological examinations, our case rates that were not supported by a diagnosis of AA are higher than those in some previous studies.…”

Association of meteorological parameters with intussusception in children aged under 2 years: results from a multisite bidirectional surveillance over 7 years in India

“…More acute appendicitis cases in children during summer months and lower during spring/autumn seasons have been reported from India, Pakistan, Iraq, China, Taiwan, Italy, Germany, Canada and the USA. [32][33][34][35][36][37][38][39] Among Chinese children, associations between acute appendicitis and temperature (p<0.01), humidity (p<0.01) and sunshine (p<0.01) were documented to support the seasonal variation. 35 Similar to intussusception, the appendicitis incidence has also declined in developed countries over decades, possibly due to changes in hygiene, sanitation, dietary practices, access to healthcare and reduction in infectious diseases.…”

“… 32–39 Among Chinese children, associations between acute appendicitis and temperature (p<0.01), humidity (p<0.01) and sunshine (p<0.01) were documented to support the seasonal variation. 35 Similar to intussusception, the appendicitis incidence has also declined in developed countries over decades, possibly due to changes in hygiene, sanitation, dietary practices, access to healthcare and reduction in infectious diseases. 40 Intussusception and acute appendicitis are intestinal problems and some of intussusceptions have associated appendicitis.…”