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Age at presentation of common pediatric surgical conditions: Reexamining dogma

Jonathan Aboagye1, Seth D Goldstein1, Jose H Salazar1

  • 1Center for Pediatric Surgical Clinical Trials & Outcomes Research, Division of Pediatric Surgery, Johns Hopkins University School of Medicine.

Journal of Pediatric Surgery
|June 4, 2014
PubMed

Insights

This study analyzed pediatric surgical conditions using national data. Ages for Hirschsprung disease, malrotation, and inguinal hernia presentation differ from common beliefs.

Area of Science:

  • Pediatric Surgery
  • Epidemiology
  • Health Services Research

Background:

  • Established ages of presentation for pediatric surgical conditions often lack robust, contemporary evidence.
  • Reliance on single-center or outdated data may misrepresent disease epidemiology.

Purpose of the Study:

  • To investigate the actual ages at presentation for common pediatric surgical conditions.
  • To utilize large national databases for a more accurate epidemiological assessment.

Main Methods:

  • Retrospective analysis of Healthcare Cost and Utilization Project (HCUP) databases (1988-2009).
  • Identification of pediatric surgical conditions including malrotation, intussusception, hypertrophic pyloric stenosis (HPS), incarcerated inguinal hernia (IH), and Hirschsprung disease (HD) using ICD-9 codes.
  • Descriptive statistical analysis of presentation ages.

Main Results:

  • Analysis of 63,750 pediatric discharges.
  • Malrotation: 58.2% presented before age 1.
  • Hypertrophic pyloric stenosis (HPS): 92.8% presented between 3-10 weeks.
  • Intussusception: 50.3% before age 1, 91.4% before age 4.
  • Incarcerated Inguinal Hernia (IH): 55.8% before age 1.
  • Hirschsprung disease (HD): 6.5% neonatal, 45.9% before age 1.

Conclusions:

  • Findings validate commonly cited presentation ages for HPS and intussusception.
  • Presentation ages for HD, malrotation, and IH in this cohort differ from established literature.
  • Highlights the need to update epidemiological data for pediatric surgical conditions.
Abstract

Keywords:
Age at presentationHirschsprung diseaseInguinal herniaIntussusceptionMalrotationPyloric stenosis

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