Predictors of appendiceal perforation in an equal access system

Area of Science:

• Medical research
• Public health
• Surgical outcomes

Background:

• Socioeconomic disparities are linked to higher perforated appendicitis rates.
• Equal-access healthcare systems aim to mitigate socioeconomic barriers to care.
• This study investigates if disparities persist in such systems.

Purpose of the Study:

• To determine if socioeconomic factors, demographics, or education influence perforated appendicitis rates within an equal-access healthcare setting.
• To identify patient and clinical characteristics associated with perforated appendicitis.

Main Methods:

• Analysis of appendectomy patients (November 2004-October 2009) at a tertiary care equal-access institution.
• Categorization by demographics, perioperative data, and sponsor rank (as a proxy for economic status).
• Multivariate logistic regression to identify factors associated with perforation.

Main Results:

• 6.4% of 680 patients presented with perforated appendicitis.
• No significant difference in perforation rates based on race, rank, or socioeconomic status.
• Older age (66-75 years) was correlated with increased perforation rates (OR 1.04, P<0.001).

Conclusions:

• In an equal-access healthcare system, older age is a significant risk factor for appendiceal perforation.
• Socioeconomic factors did not demonstrate a correlation with perforated appendicitis in this population.
• Age, rather than socioeconomic status, is the primary correlate for appendiceal perforation in this setting.