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Race and acute abdominal pain in a pediatric emergency department
Kerry Caperell1, Raymond Pitetti, Keith P Cross
1Division of Pediatric Emergency Medicine, University of Louisville, Louisville, KY 40059, USA. kerry.caperell@louisville.edu
Insights
In children with abdominal pain, constipation is the most common diagnosis. This study found no racial disparities in the evaluation, treatment, or outcomes for pediatric abdominal pain patients.
Area of Science:
- Pediatric Emergency Medicine
- Clinical Outcomes Research
- Health Disparities
Background:
- Abdominal pain is a frequent reason for pediatric emergency department (ED) visits.
- Understanding demographic and clinical factors is crucial for effective management.
- Previous research has not fully elucidated racial differences in pediatric abdominal pain care.
Purpose of the Study:
- To investigate demographic and clinical factors associated with pediatric abdominal pain.
- To analyze treatment and outcomes in children presenting to the ED with abdominal pain.
- To determine if racial differences exist in the evaluation, treatment, and outcomes of pediatric abdominal pain.
Main Methods:
- Retrospective review of electronic medical records for patients aged 1-18 years.
- Inclusion of patients presenting with abdominal pain over a 2-year period.
- Multivariate and recursive partitioning analyses to compare demographic groups (age, race, gender).
Main Results:
- Constipation was the most frequent diagnosis among 9424 patient visits.
- Appendicitis occurred in 1.9% of African American children versus 5.1% of white children.
- No significant racial differences were found in evaluation, treatment, or outcomes.
Conclusions:
- Constipation is the leading diagnosis for pediatric abdominal pain.
- The study found no evidence of racial disparities in the care of children with abdominal pain.
- Age and gender were associated with differences in admission and surgical intervention rates.
Objective:
To investigate the demographic and clinical factors of children who present to the pediatric emergency department (ED) with abdominal pain and their outcomes.
Methods:
A review of the electronic medical record of patients 1 to 18 years old, who presented to the Children's Hospital of Pittsburgh ED with a complaint of abdominal pain over the course of 2 years, was conducted. Demographic and clinical characteristics, as well as visit outcomes, were reviewed. Subjects were grouped by age, race, and gender. Results of evaluation, treatment, and clinical outcomes were compared between groups by using multivariate analysis and recursive partitioning.
Results:
There were 9424 patient visits during the study period that met inclusion and exclusion criteria. Female gender comprised 61% of African American children compared with 52% of white children. Insurance was characterized as private for 75% of white and 37% of African American children. A diagnosis of appendicitis was present in 1.9% of African American children and 5.1% of white children. Older children were more likely to be admitted and have an operation associated with their ED visit. Appendicitis was uncommon in younger children. Constipation was commonly diagnosed. Multivariate analysis by diagnosis as well as recursive partitioning analysis did not reflect any racial differences in evaluation, treatment, or outcome.
Conclusions:
Constipation is the most common diagnosis in children presenting with abdominal pain. Our data demonstrate that no racial differences exist in the evaluation, treatment, and disposition of children with abdominal pain.
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