Morbidity of peripherally inserted central catheters in pediatric complicated appendicitis

Jason P. Sulkowski, Lindsey Asti, Jennifer N. Cooper, Brian D. Kenney, Mehul V. Raval, Shawn J. Rangel, Katherine J. Deans, Peter C. Minneci

Research output: Contribution to journalArticlepeer-review

Abstract

Background The purpose of this study was to compare postoperative outcomes of pediatric patients with complicated appendicitis managed with or without a peripherally inserted central catheter (PICC). Methods Patients aged ≤18 y in the Pediatric Health Information System database with complicated appendicitis that underwent appendectomy during their index admission in 2000-2012 were grouped by whether they had a PICC placed using relevant procedure and billing codes. Rates of subsequent encounters within 30 d of discharge along with associated diagnoses and procedures were determined. A propensity score-matched (PSM) analysis was performed to account for differences in baseline exposures and severity of illness. Results We included 33,482 patients with complicated appendicitis; of whom, 6620 (19.8%) received a PICC and 26,862 (80.2%) did not. The PICC group had a longer postoperative length of stay (median 7 versus 5 d, P < 0.001) and were more likely to undergo intra-abdominal abscess drainage during the index admission (14.4% versus 2.1%, P < 0.001), and have a reencounter (17.5% versus 11.4%, P < 0.001) within 30 d of discharge. However, in the PSM cohort (n = 4428 in each group), outcomes did not differ between treatment groups, although the PICC group did have increased odds for the development of other postoperative complications (odds ratio = 3.95, 95% confidence interval: 1.45, 10.71). Conclusions After accounting for differences in severity of illness by PSM, patients managed with PICCs had a similar risk for nearly all postoperative complications, including reencounters. Postoperative management of pediatric complicated appendicitis with a PICC is not clearly associated with improved outcomes.

Original languageEnglish (US)
Pages (from-to)235-241
Number of pages7
JournalJournal of Surgical Research
Volume190
Issue number1
DOIs
StatePublished - Jul 2014

Keywords

  • Appendicitis
  • Complicated appendicitis
  • PHIS
  • PICC
  • Pediatric Health Information System
  • Peripherally inserted central catheter

ASJC Scopus subject areas

  • Surgery

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