Deprivation increases perforation risk in paediatric appendicitis

Area of Science:

• Pediatric Surgery
• Public Health
• Socioeconomic Determinants of Health

Background:

• Acute appendicitis is a common pediatric surgical emergency.
• Appendiceal perforation leads to poorer patient outcomes.
• Socioeconomic factors may influence the severity of appendicitis.

Purpose of the Study:

• To investigate the association between socioeconomic deprivation and appendiceal perforation in children.
• To determine if delayed presentation mediates the relationship between deprivation and perforation.
• To analyze appendiceal perforation risk in relation to the Scottish Index of Multiple Deprivation (SIMD).

Main Methods:

• A case-control study design was employed.
• Data were collected over a 2-year period for children undergoing appendicectomy.
• Multivariable analysis assessed associations between deprivation (SIMD), age, time to presentation, and perforation.

Main Results:

• The study included 304 pediatric patients; 44.41% experienced perforation.
• Perforation was linked to younger age and increased time to presentation.
• Higher deprivation (SIMD tertile) independently predicted perforation, irrespective of presentation delay.

Conclusions:

• Worsening socioeconomic deprivation is an independent predictor of appendiceal perforation in children.
• The link between deprivation and perforation is not explained by delayed healthcare-seeking behavior.
• Findings underscore the impact of socioeconomic status on pediatric surgical emergencies and outcomes.