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Deprivation increases perforation risk in paediatric appendicitis

Ross Bogle1, Rachel McIntyre2, Neil Patel3

  • 1Queen Elizabeth University Hospital, NHS Greater Glasgow and Clyde, Glasgow, UK ross.bogle@nhs.net.

Archives of Disease in Childhood
|April 29, 2020
PubMed

Insights

Worsening socioeconomic deprivation independently predicts appendiceal perforation in children, but not through delayed presentation. This highlights a critical link between deprivation and poorer surgical outcomes in pediatric acute 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.

Keywords:
epidemiologypaediatric surgery

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