A Nationwide Cohort Study of Outcome after Pediatric Appendicitis

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Omling, ErikLund University,Lunds universitet,Barnkirurgi,Forskargrupper vid Lunds universitet,Pediatric surgery,Lund University Research Groups,Skåne University Hospital (author)

A Nationwide Cohort Study of Outcome after Pediatric Appendicitis

Article/chapterEnglish2021

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2020-06-26
Georg Thieme Verlag KG,2021

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LIBRIS-ID:oai:lup.lub.lu.se:95a0c8a1-0ccd-446a-a980-d7fdf02bd7ef
https://lup.lub.lu.se/record/95a0c8a1-0ccd-446a-a980-d7fdf02bd7efURI
https://doi.org/10.1055/s-0040-1712508DOI

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Language:English
Summary in:English

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Introduction Children with appendicitis often present with complicated disease. The aim of this study was to describe the clinical management of pediatric appendicitis, and to report how disease severity and operative modality are associated with short- and long-term risks of adverse outcome. Materials and Methods A nationwide retrospective cohort study of all Swedish children (<18 years) diagnosed with appendicitis, 2001 to 2014 (n = 38,939). Primary and secondary outcomes were length of stay, surgical site infections, readmissions, 30-day mortality, and long-term risk of surgery for small bowel obstruction (SBO). Implications of complicated disease and operative modality were assessed with adjustment for age, gender, and trends over time. Results Complicated appendicitis was associated with longer hospital stay (4 vs. 2 days, p < 0.001), increased risk of surgical site infection (5.9 vs. 2.3%, adjusted odds ratio [aOR]: 2.64 [95% confidence interval, CI: 2.18-3.18], p < 0.001), readmission (5.5 vs. 1.2, aOR: 4.74 [95% CI: 4.08-5.53], p < 0.001), as well as long-term risk of surgery for SBO (0.7 vs. 0.2%, adjusted hazard ratio [aHR]: 3.89 [95% CI: 2.61-5.78], p < 0.001). Intended laparoscopic approach was associated with reduced risk of surgical site infections (2.3 vs. 3.1%, aOR: 0.74 [95% CI: 0.62-0.89], p = 0.001), but no overall reduction in risk for SBO; however, successful laparoscopic appendectomy was associated with less SBO during follow-up compared with open appendectomy (aHR: 0.27 [95% CI: 0.11-0.63], p = 0.002). Conclusion Children treated for complicated appendicitis are at risk of substantial short- and long-term morbidities. Fewer surgical site infections were seen after intended laparoscopic appendectomy, compared with open appendectomy, also when converted procedures were accounted for.

Subject headings and genre

MEDICIN OCH HÄLSOVETENSKAP Klinisk medicin Pediatrik hsv//swe
MEDICAL AND HEALTH SCIENCES Clinical Medicine Pediatrics hsv//eng
MEDICIN OCH HÄLSOVETENSKAP Klinisk medicin Kirurgi hsv//swe
MEDICAL AND HEALTH SCIENCES Clinical Medicine Surgery hsv//eng
complications
laparoscopic
pediatric appendicitis
small bowel obstruction
surgical site infection

Added entries (persons, corporate bodies, meetings, titles ...)

Salö, MartinLund University,Lunds universitet,Barnkirurgi,Forskargrupper vid Lunds universitet,Pediatric surgery,Lund University Research Groups,Skåne University Hospital(Swepub:lu)med-ms21 (author)
Saluja, SaurabhCornell University(Swepub:lu)sa8082sa (author)
Bergbrant, SannaLund University,Lunds universitet,Kirurgi och folkhälsa,Forskargrupper vid Lunds universitet,Surgery and public health,Lund University Research Groups(Swepub:lu)su2461be (author)
Olsson, LouiseLund University,Lunds universitet,Kirurgi och folkhälsa,Forskargrupper vid Lunds universitet,Surgery and public health,Lund University Research Groups(Swepub:lu)lo4608ol (author)
Björk, JonasLund University,Lunds universitet,Kirurgi och folkhälsa,Forskargrupper vid Lunds universitet,Surgery and public health,Lund University Research Groups,Skåne University Hospital(Swepub:lu)ymed-jbj (author)
Hagander, LarsLund University,Lunds universitet,Kirurgi och folkhälsa,Forskargrupper vid Lunds universitet,Surgery and public health,Lund University Research Groups,Skåne University Hospital(Swepub:lu)med-lhd (author)
BarnkirurgiForskargrupper vid Lunds universitet (creator_code:org_t)

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In:European Journal of Pediatric Surgery: Georg Thieme Verlag KG31:2, s. 191-1980939-72481439-359X

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MEDICAL AND HEALTH SCIENCES: MEDICAL AND HEAL ...; and Clinical Medicin ...; and Pediatrics

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