Effect of hospital type on the treatment of acute appendicitis in teenagers

Cristen N. Litz, David J. Ciesla, Paul D. Danielson, Nicole M. Chandler

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Teenagers receive appendicitis care at both adult and pediatric facilities. The purpose of this study was to evaluate outcomes following treatment of acute appendicitis in teenagers based on the type of hospital facility. Methods: Patients aged 13–17 years with acute appendicitis who were discharged from acute care hospitals from 2009 to 2014 were identified using a statewide discharge dataset. Hospitals were classified as pediatric or adult and outcomes were compared. Results: There were 5585 patients treated in adult hospitals and 1625 in pediatric hospitals. Fewer patients at adult hospitals had complicated appendicitis (20.4% vs. 33.0%, p < 0.01). Open appendectomy occurred more often in adult hospitals compared to pediatric hospitals (12.6% vs. 6.0%, p < 0.01). Pediatric hospitals had higher rates of non-operative management (10% vs. 3.4%, p < 0.01) and percutaneous drain placement (1.2% vs. 0.4%, p < 0.01). Postoperative complication rates did not significantly differ between hospital types. Conclusion: Most teenagers undergo appendectomy at adult facilities; however, a greater proportion of younger patients and patients with complicated appendicitis is treated at pediatric hospitals. Treatment at a freestanding children's hospital results in lower rates of open procedures and no difference in complications. Opportunities may exist to standardize care across treating facilities to optimize outcomes and resource use. Type of study: Prognosis study. Level of evidence: II.

Original languageEnglish (US)
Pages (from-to)446-448
Number of pages3
JournalJournal of pediatric surgery
Volume53
Issue number3
DOIs
StatePublished - Mar 2018

Keywords

  • Appendicitis
  • Children's hospital
  • Outcomes
  • Pediatric
  • Regionalization

ASJC Scopus subject areas

  • Surgery
  • Pediatrics, Perinatology, and Child Health

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