The Impact of Socioeconomic Status on Appendiceal Perforation in Pediatric Appendicitis
| Autor: | Mary T. Austin, Luke R. Putnam, Kevin P. Lally, Caroline M. Kellagher, Hoang Nguyen, KuoJen Tsao |
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| Rok vydání: | 2015 |
| Předmět: |
Male
Pediatrics medicine.medical_specialty Multivariate analysis Adolescent Perforation (oil well) Social class Patient Readmission 03 medical and health sciences 0302 clinical medicine Medicine Appendectomy Humans Surgical Wound Infection 030212 general & internal medicine Child Socioeconomic status Retrospective Studies Medical Assistance business.industry Age Factors Infant Retrospective cohort study Censuses social sciences Length of Stay medicine.disease Appendicitis United States Social Class 030220 oncology & carcinogenesis Child Preschool Pediatrics Perinatology and Child Health Cohort Multivariate Analysis population characteristics Household income Female business |
| Zdroj: | The Journal of pediatrics. 170 |
| ISSN: | 1097-6833 |
| Popis: | 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.We reviewed all patients18 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.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 with12th 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.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. |
| Databáze: | OpenAIRE |
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