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Brief Report: Association of Complicated Appendicitis in Children with Autism Spectrum Disorders
Patrick T Reeves1,2, Apryl Susi3, Elizabeth Hisle-Gorman3
1Department of Pediatrics, Uniformed Services University of the Health Sciences, Bethesda, MD, USA. patrick.t.reeves.mil@mail.mil.
Insights
Children with autism spectrum disorder (ASD) face a higher risk of complicated appendicitis, including perforation and sepsis, particularly in older adolescents. Healthcare providers should maintain heightened awareness for these risks in ASD patients.
Area of Science:
- Pediatric Surgery
- Developmental Pediatrics
- Epidemiology
Background:
- Appendicitis is a common pediatric surgical emergency with potential for severe complications.
- Autism spectrum disorder (ASD) affects neurodevelopment and may influence health outcomes.
- Understanding appendicitis risk in children with ASD is crucial for timely diagnosis and management.
Purpose of the Study:
- To investigate the risk of appendicitis and its complications in children with ASD compared to neurotypical (NT) children.
- To identify specific complications and age groups within the ASD population that are at higher risk.
Main Methods:
- A retrospective cohort study utilizing data from 2000 to 2013.
- Inclusion of 292,572 children, with 48,762 diagnosed with ASD.
- Analysis of appendicitis incidence, perforation, and sepsis rates between ASD and NT groups.
Main Results:
- The incidence of appendicitis was 8.66 cases per 10,000 person-years in ASD children (P > 0.05).
- Children with ASD aged 15-17 years showed an increased risk of perforation (OR 2.25; 95% CI 1.15-4.42).
- An elevated odds of sepsis was observed in ASD children (OR 3.44, 95% CI 1.43-8.27).
Conclusions:
- Children with ASD are not at a higher overall risk for appendicitis.
- However, ASD children, especially adolescents, have an increased risk for complicated appendicitis, including perforation and sepsis.
- Healthcare providers need increased vigilance for complicated appendicitis in children with ASD.
Abstract:
Appendicitis is the most common surgical emergency in children and can lead to significant complications. The aim of our study was to determine whether children with autism spectrum disorders (ASD) are at increased risk for appendicitis and its complications compared to neurotypical (NT) peers. From 2000 to 2013, 292,572 children were included (n = 48,762 ASD). ASD children exhibited an incidence of 8.66 appendicitis cases per 10,000 person-years, P > 0.05. There was an increased risk of perforation in ASD children age 15-17 years-old (OR 2.25; 95% CI 1.15-4.42) as well as an increased odds of sepsis (OR 3.44, 95% CI 1.43-8.27). Providers should display heightened awareness for the risk of complicated appendicitis in children with ASD.
