Pediatric patients transferred for operative management of appendicitis: Are they at a disadvantage?

Sandra M. Farach, Paul D. Danielson, Nebbie Walford, Richard P. Harmel, Nicole M. Chandler

Research output: Contribution to journalArticle

Abstract

Purpose Many pediatric patients are initially diagnosed with appendicitis at referring hospitals and are subsequently transferred to pediatric facilities. We aimed to compare outcomes of patients transferred to a pediatric referral center to those who present primarily for operative management of appendicitis. Methods: A retrospective review of 326 patients with operative appendicitis from July 2012 to July 2013 was performed. Demographic data, clinical parameters, and outcomes were analyzed. Results: Transferred (n = 222, 68%) and primary patients (n = 104, 32%) were similar except for mean age (primary 12.4 vs. transferred 11.2 years, p < 0.01). Computed tomography scans were performed in 80% of transferred compared to 40% of primary patients. Primary patients were more likely to present between the hours of 09:00 and 17:59 (52%), while transferred arrived equally across all hours. Both groups were more likely to present with acute appendicitis (primary 56% vs. transfer 61%, p = NS). There was no difference in time of diagnosis to time of appendectomy, length of hospital stay, or 30 day complications (primary 8.6% vs. transfer 5.8%, p = NS). Conclusions: Patients transferred for definitive care of appendicitis are not found to have more advanced disease or have increased complications; however, they are exposed to significantly more ionizing radiation during evaluation for appendicitis.

Original languageEnglish (US)
Pages (from-to)1579-1582
Number of pages4
JournalJournal of Pediatric Surgery
Volume50
Issue number9
DOIs
StatePublished - Sep 1 2015

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Appendicitis
Pediatrics
Length of Stay
Appendectomy
Ionizing Radiation
Referral and Consultation
Tomography
Demography

Keywords

  • Appendectomy
  • Appendicitis
  • Key words Pediatric
  • Transfer

ASJC Scopus subject areas

  • Surgery
  • Pediatrics, Perinatology, and Child Health
  • Medicine(all)

Cite this

Pediatric patients transferred for operative management of appendicitis : Are they at a disadvantage? / Farach, Sandra M.; Danielson, Paul D.; Walford, Nebbie; Harmel, Richard P.; Chandler, Nicole M.

In: Journal of Pediatric Surgery, Vol. 50, No. 9, 01.09.2015, p. 1579-1582.

Research output: Contribution to journalArticle

Farach, Sandra M. ; Danielson, Paul D. ; Walford, Nebbie ; Harmel, Richard P. ; Chandler, Nicole M. / Pediatric patients transferred for operative management of appendicitis : Are they at a disadvantage?. In: Journal of Pediatric Surgery. 2015 ; Vol. 50, No. 9. pp. 1579-1582.
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abstract = "Purpose Many pediatric patients are initially diagnosed with appendicitis at referring hospitals and are subsequently transferred to pediatric facilities. We aimed to compare outcomes of patients transferred to a pediatric referral center to those who present primarily for operative management of appendicitis. Methods: A retrospective review of 326 patients with operative appendicitis from July 2012 to July 2013 was performed. Demographic data, clinical parameters, and outcomes were analyzed. Results: Transferred (n = 222, 68{\%}) and primary patients (n = 104, 32{\%}) were similar except for mean age (primary 12.4 vs. transferred 11.2 years, p < 0.01). Computed tomography scans were performed in 80{\%} of transferred compared to 40{\%} of primary patients. Primary patients were more likely to present between the hours of 09:00 and 17:59 (52{\%}), while transferred arrived equally across all hours. Both groups were more likely to present with acute appendicitis (primary 56{\%} vs. transfer 61{\%}, p = NS). There was no difference in time of diagnosis to time of appendectomy, length of hospital stay, or 30 day complications (primary 8.6{\%} vs. transfer 5.8{\%}, p = NS). Conclusions: Patients transferred for definitive care of appendicitis are not found to have more advanced disease or have increased complications; however, they are exposed to significantly more ionizing radiation during evaluation for appendicitis.",
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