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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.
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.
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