Geographic and socioeconomic predictors of perforated appendicitis: A national Canadian cohort study

Akhtar-Danesh, Gileh-Gol; Doumouras, Aristithes G.; Flageole, Hélène; Hong, Dennis

doi:10.1016/j.jpedsurg.2018.10.065

Cited by 23 publications

(24 citation statements)

References 25 publications

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“…Internationally, perforation rates are higher for those treated with appendicitis in rural areas even in high-income countries. 8,12,13 In a Canadian study, perforation rates were a direct function of spatial isolation and independent of socio-economic status. 8 One factor responsible for this may be the delay rural patients experience accessing surgery.…”

Section: Discussionmentioning

confidence: 99%

“…8,12,13 In a Canadian study, perforation rates were a direct function of spatial isolation and independent of socio-economic status. 8 One factor responsible for this may be the delay rural patients experience accessing surgery. Previous studies looking specifically at delay to appendicectomy have suggested that prolonged delay (greater than 24 h) is associated with worse outcomes, but delays less than this may have little effect.…”

Section: Discussionmentioning

confidence: 99%

“…7 Even in high-income countries with access to universal healthcare, complicated appendicitis was directly linked to distance from available surgical services. 8 It is unknown if similar issues exist in regional and rural hospitals in NZ as there is a paucity of rural surgical research nationally. In this multicentre study, the management and outcomes of those presenting with acute appendicitis are analysed across several rural and regional South Island hospitals comparing outcomes to their referring metropolitan centre.…”

Section: Introductionmentioning

confidence: 99%

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Multicentre study of appendicitis management comparing a large South Island metropolitan hospital, to its referring regional and rural centres

Withers

Hepburn

Palmer

et al. 2021

ANZ Journal of Surgery

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Background: Globally, patients presenting with acute surgical disease in rural areas have poorer outcomes when compared to urban areas; little data are available regarding outcomes for New Zealand (NZ) rural patients. This study aimed to compare the surgical management of appendicitis in a large metropolitan centre with its regional referral centres. Methods: In this retrospective cohort study, patient data were collated from the studied centres between November 2014 and October 2019. In addition to patient demographics, patterns of referral and presentation, the primary outcome was time to the theatre; secondary outcomes were perforation rates, length of stay and complications. Data are presented as medians (interquartile range). Results: A total of 3533 patients underwent appendicectomy over the period studied. For those presenting directly to the metropolitan centre, the median wait-time to the theatre was 16 h (9.2-23.2); if patients were transferred, they waited for 20.8 h (13.6-27). Patients presenting to regional centres waited for 7.6 h (4.5-15.4, P < 0.001). Perforation rates for transferred patients were 31% which was greater than for those presenting to the metropolitan (20%) or regional centres (17%, P = 0.014). Complications were also highest in transferred patients (20%) when compared to the metropolitan (17%) or regional centres (10%, P < 0.001). Conclusion: Patients who were transferred to Christchurch Hospital from rural centres without surgical services had a longer wait-time than those who presented to Christchurch Hospital directly or were treated in regional centres. This was associated with higher rates of perforated appendicitis. 54 (42-69) 41 (32-57)** 45 (35-61)** 51 (39-66) 57 (47-76)* <0.0001 54 (42-70) 45 (34-60) <0.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Multicentre study of appendicitis management comparing a large South Island metropolitan hospital, to its referring regional and rural centres

Withers

Hepburn

Palmer

et al. 2021

ANZ Journal of Surgery

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“…Although numerous epidemiological studies on complicated appendicitis have been conducted, most focused on children or older adults; relatively few focused on people with disabilities, especially with a long observation period. Previous studies were mainly concerned with the incidence of complicated appendicitis ( 15 – 17 ), differences in the incidence of complicated appendicitis between patients with and without disabilities, and factors affecting complicated appendicitis in people with disabilities. Our target population was people with disabilities diagnosed with complicated appendicitis; the comparison group was patients with complicated appendicitis without disabilities and the outcome variable was the incidence of complicated appendicitis.…”

Section: Introductionmentioning

confidence: 99%

Complicated Appendicitis Among Adults With and Without Disabilities: A Cross-Sectional Nationwide Study in South Korea

Yeob

Kim

Park

et al. 2022

Front. Public Health

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ObjectiveAppendicitis is usually diagnosed based on a reliable set of signs and symptoms, and can be effectively treated with surgery, with low morbidity and mortality rates. However, appendicitis is often overlooked in vulnerable populations, including people with disabilities. This study compared 10-year trends of complicated appendicitis between South Koreans with a disability, according to disability severity and type, and those without disabilitiesMethodsTo identify cases of appendicitis, we used the DRG codes in the National Health Information Database of South Korea. Patients with appendicitis were classified in terms of severity based on the DRG codes. Age-standardized incidence rates were calculated for each year during 2008–2017 according to the presence, type, and severity of the disability. Factors associated with complicated appendicitis were examined by multivariate logistic regression using the most recent data (i.e., 2016–2017).ResultsThe incidence of complicated appendicitis was higher in people with disabilities, especially those with severe disabilities (26.9 vs. 11.6%). This difference was particularly marked when considering those with a severe disability (aOR = 1.868, 95% CI:1.511–2.309), internal organ problems (aOR = 10.000, 95% CI:5.365–18.638) or a mental disability (aOR = 2.779, 95% CI:1.563–4.939).ConclusionsThe incidence of complicated appendicitis was higher in people with disability than in those without disability in all years. There was a substantial difference in the incidence of complicated appendicitis between the severe disability and non-disabled groups. Among the various disability types, the incidence of complicated appendicitis was highest for major internal organ problems, followed by intellectual or psychological disabilities. Our findings may be explained by barriers to healthcare access among people with disabilities, particularly those with a severe disability, internal organ problem, or mental disability.

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“…Rurality has been shown to be a predictor of worse surgical outcomes compared to those for urban residents. [1][2][3][4][5] Among the common causes of appendicitis, obstruction of the appendiceal lumen by a fecalith and hyperplasia of the lymphoid follicle have been proposed. It has been reported that appendicitis has a higher incidence in communities with high consumption of potatoes, sugar, and cereals and a lower incidence in communities with high consumption of nonpotato vegetables.…”

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confidence: 99%

Incidence of appendicitis during SARS‐CoV‐2 pandemic quarantine

Zampieri

Murri²,

Cinquetti³

et al. 2021

Pediatrics International

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Geographic and socioeconomic predictors of perforated appendicitis: A national Canadian cohort study

Cited by 23 publications

References 25 publications

Multicentre study of appendicitis management comparing a large South Island metropolitan hospital, to its referring regional and rural centres

Multicentre study of appendicitis management comparing a large South Island metropolitan hospital, to its referring regional and rural centres

Complicated Appendicitis Among Adults With and Without Disabilities: A Cross-Sectional Nationwide Study in South Korea

Incidence of appendicitis during SARS‐CoV‐2 pandemic quarantine

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