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The Impact of Socioeconomic Status on Appendiceal Perforation in Pediatric Appendicitis.
Putnam, Luke R; Tsao, KuoJen; Nguyen, Hoang T; Kellagher, Caroline M; Lally, Kevin P; Austin, Mary T.
Afiliação
  • Putnam LR; Department of Pediatric Surgery, Children's Memorial Hermann Hospital, The University of Texas Medical School at Houston, Houston, TX.
  • Tsao K; Department of Pediatric Surgery, Children's Memorial Hermann Hospital, The University of Texas Medical School at Houston, Houston, TX; Department of Surgical Oncology, Children's Cancer Hospital, The University of Texas MD Anderson Cancer Center, Houston, TX.
  • Nguyen HT; Department of Health Services Research, The University of Texas MD Anderson Cancer Center, Houston, TX.
  • Kellagher CM; Department of Pediatric Surgery, Children's Memorial Hermann Hospital, The University of Texas Medical School at Houston, Houston, TX.
  • Lally KP; Department of Pediatric Surgery, Children's Memorial Hermann Hospital, The University of Texas Medical School at Houston, Houston, TX; Department of Surgical Oncology, Children's Cancer Hospital, The University of Texas MD Anderson Cancer Center, Houston, TX.
  • Austin MT; Department of Pediatric Surgery, Children's Memorial Hermann Hospital, The University of Texas Medical School at Houston, Houston, TX; Department of Surgical Oncology, Children's Cancer Hospital, The University of Texas MD Anderson Cancer Center, Houston, TX. Electronic address: maustin@mdanderson.o
J Pediatr ; 170: 156-60.e1, 2016 Mar.
Article em En | MEDLINE | ID: mdl-26922766
OBJECTIVE: To assess the impact of socioeconomic status (SES) on pediatric appendicitis outcomes using the validated Agency for Healthcare Research and Quality (AHRQ) SES Index and incorporating block-group data. STUDY DESIGN: We reviewed all patients <18 years old who underwent appendectomy for acute appendicitis from 2009-2013 at our institution. Patient addresses were geocoded and linked to 2010 US Census SES block-group data to determine composite AHRQ SES Index scores based on 7 publically reported SES variables. The primary outcome was appendiceal perforation, and the impact of SES scores, age, race, and insurance status on perforation rates were assessed through regression analyses. RESULTS: Of 1501 patients, 510 (34%) had perforated appendicitis. On bivariate analysis, components of the SES Index associated with an increased perforation rate included lower household income, lower percentage of adults with college education, and higher percentage of adults with <12th grade education (all P < .05). On multivariate analysis, age ≤ 10 years (OR 1.7, 95% CI 1.4-2.2) and public insurance (OR 1.5, 95% CI 1.2-2.0) were associated with increased odds of perforation. CONCLUSIONS: This study used the AHRQ SES scoring system to evaluate SES and its influence on appendiceal perforation. Among our cohort of pediatric patients, the risk of perforation was multifactorial, and younger age and public insurance were stronger predictors of perforation than SES.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Apendicectomia / Apendicite / Classe Social Tipo de estudo: Observational_studies / Prognostic_studies / Risk_factors_studies Aspecto: Determinantes_sociais_saude Limite: Adolescent / Child / Child, preschool / Female / Humans / Infant / Male País/Região como assunto: America do norte Idioma: En Revista: J Pediatr Ano de publicação: 2016 Tipo de documento: Article País de publicação: Estados Unidos
Texto completo
Adicionar na Minha BVS
Imprimir
XML
PubMed Links
Buscar no Google

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Apendicectomia / Apendicite / Classe Social Tipo de estudo: Observational_studies / Prognostic_studies / Risk_factors_studies Aspecto: Determinantes_sociais_saude Limite: Adolescent / Child / Child, preschool / Female / Humans / Infant / Male País/Região como assunto: America do norte Idioma: En Revista: J Pediatr Ano de publicação: 2016 Tipo de documento: Article País de publicação: Estados Unidos