CAPS PaperDeterminants of appendicitis outcomes in Canadian children
Section snippets
Data source
Canadian data for the years 2004–2010 were obtained from the Discharge Abstract Database (DAD), managed by the Canadian Institute for Health Information (CIHI). DAD contains mandatory discharge data from all hospitals in Canada, except those in Quebec. Data were coded using ICD-10-CA. The database includes diagnoses, patient demographics, treating physician information, and hospital characteristics. The study was approved by the McGill University Faculty of Medicine Institutional Review Board
Results
During the study period, 47,840 patients were considered potential subjects for the study. Of those, 41,405 met the inclusion criteria (Fig. 1). Age, gender, region, and hospital type were available for all patients. Several subsets of patients were removed from specific analyses: 5.1% received treatment from neither a pediatric nor a general surgeon; 16.2% did not have a clearly identified domicile status; 1.9% had a non-valid socioeconomic status. The demographics of the study population are
Discussion
Acute appendicitis is the most common surgical illness in children, and appendectomy is one of the most common surgical procedures performed in this age group. Any improvement in outcomes, even if small, may therefore have a profound effect on health care resource utilization and cost. An understanding of the determinants of these outcomes is the first step towards any attempts at improving them. Most of the population-based studies concerning pediatric appendicitis have come from the United
Acknowledgment
We would like to thank Dr. Xianming Tan of the Biostatistics Core Facility, McGill University Health Centre Research Institute for providing assistance with the statistical analyses.
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2022, Journal of Pediatric SurgeryCitation Excerpt :Of note, no significant differences in complications or length of stay were identified among rural children undergoing pyloromyotomy at urban hospitals. In contrast, Cheong et al. utilized Canadian Institute for Healthy Information data to evaluate the likelihood of having perforated appendicitis or negative appendectomy among children cared for at all Canadian hospitals, except those in Quebec, based upon domicile (rural vs. urban) and Canadian region [37]. No differences in rates of misdiagnosis or perforation were identified among rural patients.
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2022, British Journal of AnaesthesiaA population-based cohort examining factors affecting all-cause morbidity and cost after pediatric appendectomy: Does annual adult procedure volume matter?
2019, American Journal of SurgeryCitation Excerpt :Interestingly, in this study, laparoscopy was associated with significantly decreased morbidity and costs. The percentage of laparoscopic cases in this cohort was 69.1% in contrast to Cheong et al. who found a majority open approach in Canada between 2004 and 2010.1 A Cochrane review comparing laparoscopic and open appendectomy reported various advantages of laparoscopic appendectomy for both adult and pediatric patients, including decreased surgical site infection, reduced postoperative pain, and decreased length of stay; however this review did find an increased rate of postoperative abscess after laparoscopic appendectomy.18
Geographic and socioeconomic predictors of perforated appendicitis: A national Canadian cohort study
2019, Journal of Pediatric SurgeryCitation Excerpt :The overall rate of perforated appendicitis within our study was 31.5%, which is comparable to studies from Europe and the United States [3,13,14]. We found a slightly higher perforation rate in females and younger children, a phenomenon that has been well described owing to the increased difficulty of diagnosis in these groups [1]. We also observed that children with appendiceal perforation and those with comorbidities were more likely to suffer complications, which is in keeping with the existing literature [3,15].
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