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Related Experiment Videos

Paediatric appendicectomy in NSW: changes in practice over time and between groups

G R Close1, R L Rushworth, M I Rob

  • 1Epidemiology and Health Services Evaluation Branch, NSW Health Department, North Sydney, Australia.

Journal of Quality in Clinical Practice
|March 1, 1995
PubMed
Summary

Appendicectomy rates in children aged 0-14 in New South Wales significantly decreased between 1986 and 1990. While overall outcomes improved, higher perforation rates in the youngest children remain a concern.

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Area of Science:

  • Pediatric Surgery
  • Public Health Surveillance
  • Epidemiology

Background:

  • Appendicectomy is a common surgical procedure for appendicitis in children.
  • Understanding trends in appendicectomy rates and outcomes is crucial for evaluating surgical practices.
  • Previous studies have indicated variations in appendicectomy rates and outcomes across different regions and demographics.

Purpose of the Study:

  • To examine trends in appendicectomy rates among children aged 0-14 years in New South Wales (NSW) between 1986 and 1989/90.
  • To analyze appendicectomy outcomes, including rates of perforation and negative appendicectomy, within this pediatric population.
  • To identify geographic and demographic variations in appendicectomy patterns and outcomes.

Main Methods:

  • Utilized routinely collected hospital separation data from NSW for the period 1986-1989/90.

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  • Analyzed overall appendicectomy rates, rates of appendicectomy with confirmed appendicitis, and rates of perforation and negative appendicectomy.
  • Compared rates across different geographic areas and age groups (0-4, 5-9, 10-14 years) and by sex.

    • Main Results:

    • Overall appendicectomy rates decreased significantly from 1986 to 1989/90 (P < 0.01).
    • Rates of appendicectomy with confirmed appendicitis also significantly declined (P < 0.01).
    • Proportions of perforation (10%) and negative appendicectomy (28%) remained stable and comparable to previous reports. Higher negative appendicectomy rates were observed in females (35%) versus males (25%). The youngest age group (0-4 years) exhibited the highest perforation rate (27%).

    Conclusions:

    • Appendicectomy is performed less frequently in NSW children now compared to previous years, with favorable outcomes.
    • While perforation rates are relatively low, the high proportion in the youngest children warrants attention.
    • Geographic variations exist, but perforation rates were not systematically linked to negative appendicectomy rates.