Determinants of appendicitis outcomes in Canadian children

Cheong, Li Hsia Alicia; Emil, Sherif

doi:10.1016/j.jpedsurg.2014.02.074

Cited by 34 publications

(29 citation statements)

References 21 publications

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“…As found by others [1,5,11,12], girls had a significantly higher frequency of negative appendectomies. Of note, despite no difference in time to appendectomy, boys had a higher perforation frequency, which has been reported in adult men before [13,14], but not in boys [12].…”

Section: Discussionsupporting

confidence: 75%

Appendicitis in children from a gender perspective

et al. 2015

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In children with appendicitis, there are some gender differences. Girls had negative appendectomies more often, despite having more preoperative imaging and they had operative complications more frequently, despite having less frequent perforations. Boys had a higher frequency of perforation even though their time to appendectomy equaled that of girls. These findings and the reasons behind them must be further studied.

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Section: Discussionsupporting

confidence: 75%

Appendicitis in children from a gender perspective

et al. 2015

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“…Characteristics of the 9 included studies 8 , 11 – 18 are shown in Table 1 and results from the studies are provided in Table 2 . In total the studies comprised 50,963 children who were managed by general surgery units and 15,032 children who were managed by pediatric surgery units.…”

Section: Resultsmentioning

confidence: 99%

Systematic Review and Meta-Analysis on the Influence of Surgeon Specialization on Outcomes Following Appendicectomy in Children

et al. 2015

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The aim of this study is to assess the influence of surgeon specialization on outcomes following appendicectomy in children.General surgeons and pediatric surgeons manage appendicitis in children; however, the influence of subspecialization on outcomes remains unclear.Two authors searched Medline and Embase to identify relevant studies. Eligible studies were comparative and provided data on children who had appendicectomy while under the care of general or pediatric surgical teams. Two authors initially screened titles and abstracts and then full text manuscripts were evaluated. Data were extracted by 2 authors using an electronic spreadsheet. Pooled risk ratios and pooled mean differences were used in analyses.We identified 9 relevant studies involving 50,963 children who were managed by general surgery teams and 15,032 children who were managed by pediatric surgery teams. A normal appendix was removed in 4660/48,105 children treated by general surgery units and in 889/14,760 children treated by pediatric units (pooled risk ratio 1.79; 95% confidence interval [CI] 1.26–2.54; P = 0.001). Children managed in general units had shorter mean hospital stays compared with children managed in pediatric units (pooled mean difference −0.70 days; 95%CI −1.09 to −0.30; P = 0.0005). There were no significant differences regarding wound infections, intra-abdominal abscesses, readmissions, or mortality.We found that children who were managed by specialized pediatric surgery teams had lower rates of negative appendicectomy although mean length of stay was longer. Our article is based upon a group of heterogeneous and mostly retrospective studies and therefore there is little external validity. Further studies are needed.

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“…The notion that younger and sicker children are treated with specialized care has been previously reported. [1][2][3][4][5][6][7][8][9][10][11] One of the first studies to examine specialized care for pediatric appendicitis showed much greater rates of postoperative complications when complicated appendicitis was treated by general surgeons. 5 Kokoska et al 1 subsequently demonstrated that pediatric surgeons treat younger patients with more severe disease, yet their hospital duration of stay was shorter than older children treated by general surgeons.…”

Section: Discussionmentioning

confidence: 99%