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Spatial-temporal clusters of pediatric perforated appendicitis in California

Kristy Schwartz1, Margaret Nguyen1

  • 1Division of Emergency Medicine, Department of Pediatrics, Rady Children's Hospital San Diego/University of California San Diego, 3020 Children's Way, MC5075 - Emergency Medicine, San Diego, CA 92123, United States.

Journal of Pediatric Surgery
|March 23, 2021
PubMed

Insights

Pediatric perforated appendicitis shows persistent spatial-temporal clusters in California, particularly in rural areas. Poverty is a significant factor linked to higher rates, highlighting the need to address socioeconomic disparities.

Area of Science:

  • Pediatric Surgery
  • Public Health
  • Geographic Epidemiology

Background:

  • Perforated appendicitis is a recognized child health disparity with known regional variations in the US.
  • Spatial-temporal patterns of pediatric perforated appendicitis in California have not been previously described.

Purpose of the Study:

  • To analyze spatial-temporal patterns of pediatric perforated appendicitis in California.
  • To identify population characteristics associated with identified clusters of perforated appendicitis.

Main Methods:

  • Geocoded risk-adjusted perforated appendicitis rates (per 1000 cases) for patients aged 1-17 from 2005-2015.
  • Space-time cube analysis to detect hot spot trends.
  • Logistic regression and multivariate analysis to assess rural classification and socioeconomic factors.

Main Results:

  • Identified 11 persistent spatial-temporal hot spots of perforated appendicitis across California (2005-2015).
  • Rural micropolitan counties had significantly higher odds (14x) of being a hot spot (p<0.05).
  • Poverty was a significant predictor of higher median risk-adjusted perforated appendicitis rates (p<0.004).

Conclusions:

  • Eleven persistent hot spots of pediatric perforated appendicitis were identified in California over a decade.
  • Understanding geographic and socioeconomic factors is crucial for addressing this child health disparity.
Abstract

Keywords:
GISGeographic disparityHealth disparitiesPediatric perforated appendicitisSpatial–temporal analysis

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