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Andreas Persson

Universitetslektor

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Nationwide study of appendicitis in children

Författare

  • E. Omling
  • M. Salö
  • S. Saluja
  • S. Bergbrant
  • L. Olsson
  • A. Persson
  • J. Björk
  • L. Hagander

Summary, in English

Background: Paediatric surgical care is increasingly being centralized away from low-volume centres, and prehospital delay is considered a risk factor for more complicated appendicitis. The aim of this study was to determine the incidence of paediatric appendicitis in Sweden, and to assess whether distance to the hospital was a risk factor for complicated disease. Methods: A nationwide cohort study of all paediatric appendicitis cases in Sweden, 2001–2014, was undertaken, including incidence of disease in different population strata, with trends over time. The risk of complicated disease was determined by regression methods, with travel time as the primary exposure and individual-level socioeconomic determinants as independent variables. Results: Some 38 939 children with appendicitis were identified. Of these, 16·8 per cent had complicated disease, and the estimated risk of paediatric appendicitis by age 18 years was 2·5 per cent. Travel time to the treating hospital was not associated with complicated disease (adjusted odds ratio (OR) 1·00 (95 per cent c.i. 0·96 to 1·05) per 30-min increase; P = 0·934). Level of education (P = 0·177) and family income (P = 0·120) were not independently associated with increased risk of complicated disease. Parental unemployment (adjusted OR 1·17, 95 per cent c.i. 1·05 to 1·32; P = 0·006) and having parents born outside Sweden (1 parent born in Sweden: adjusted OR 1·12, 1·01 to 1·25; both parents born outside Sweden: adjusted OR 1·32, 1·18 to 1·47; P < 0·001) were associated with an increased risk of complicated appendicitis. Conclusion: Every sixth child diagnosed with appendicitis in Sweden has a more complicated course of disease. Geographical distance to the surgical facility was not a risk factor for complicated appendicitis.

Avdelning/ar

  • Barnkirurgi
  • Centrum för geografiska informationssystem (GIS-centrum)
  • Institutionen för naturgeografi och ekosystemvetenskap
  • EPI@LUND
  • Kirurgi och folkhälsa
  • eSSENCE: The e-Science Collaboration
  • EpiHealth: Epidemiology for Health

Publiceringsår

2019-08-06

Språk

Engelska

Sidor

1623-1631

Publikation/Tidskrift/Serie

British Journal of Surgery

Volym

106

Issue

12

Dokumenttyp

Artikel i tidskrift

Förlag

Oxford University Press

Ämne

  • Public Health, Global Health, Social Medicine and Epidemiology

Status

Published

Forskningsgrupp

  • Pediatric surgery
  • EPI@LUND
  • Surgery and public health

ISBN/ISSN/Övrigt

  • ISSN: 0007-1323