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Using shock index, pediatric age adjusted (SIPA) to predict prolonged length of stay in perforated appendicitis: a

Alexandra Barone-Camp1, Amanda Louiselle2, Samantha Bothwell3

  • 1Division of Pediatric Surgery, Children's Hospital Colorado, University of Colorado School of Medicine, 13123 E 16th Ave. Box 323, Aurora, CO, 80045, USA. alexandra.barone-camp@cuanschutz.edu.

Pediatric Surgery International
|November 5, 2024
PubMed

Insights

Elevated Shock Index, Pediatric Age Adjusted (SIPA) in children with appendicitis indicates a higher risk of perforation and predicts longer hospital stays. This finding supports using SIPA for triage and family counseling.

Area of Science:

  • Pediatric Surgery
  • Emergency Medicine
  • Clinical Outcomes Research

Background:

  • Hospital length of stay (LOS) for pediatric appendicitis is challenging to predict.
  • Shock Index, Pediatric Age Adjusted (SIPA) is a validated tool for identifying severe injury and predicting mortality in pediatric trauma and ICU patients.

Purpose of the Study:

  • To determine if elevated SIPA at presentation and its normalization time can identify children with perforated appendicitis.
  • To assess if SIPA can predict hospital LOS in pediatric appendicitis cases.

Main Methods:

  • Retrospective cohort study of 169 children (1-17 years) admitted for appendicitis in 2021.
  • Primary outcomes: perforated appendicitis and hospital LOS.
  • Generalized linear regressions adjusted for age, sex, fecalith, temperature, and time to OR.

Main Results:

  • Elevated SIPA was significantly associated with perforated appendicitis (p=0.0002) and longer hospital LOS (p<0.0001).
  • Patients with elevated SIPA had 5.4 times higher odds of perforation and 2.0 times longer LOS.
  • Elevated SIPA also predicted longer recovery times, including toleration of regular diet and duration of antibiotics.

Conclusions:

  • Elevated SIPA at presentation is a strong indicator of perforated appendicitis in children.
  • Incorporating SIPA into the triage process for appendicitis can improve patient identification and management.
  • SIPA can aid in counseling families regarding expected recovery trajectories.
Abstract

Keywords:
Length of stayPediatric age adjusted (SIPA)Perforated appendicitisShock index

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