The effect of race on outcomes for appendicitis in children: a nationwide analysis

Abstract

Background: We sought to examine the impact of race on the management and outcomes of appendicitis in children aged 20 years or younger.

Methods: We studied 96,865 inpatient admissions for children undergoing an appendectomy for acute appendicitis in 2009 using the Kids' Inpatient Database.

Results: Perforation at presentation was more common among African-Americans and Hispanics than Caucasians (27.5% and 32.5%, respectively, vs 23.9%, P < .001). African-Americans were less likely to have a laparoscopic procedure (odds ratio [OR]: .839, P < .001) and more likely to experience a complication (OR: 1.753, P < .001). Hispanics were also more likely to have a complication (OR: 1.123, P = .001). African-Americans and Hispanics remained in the hospital for .73 more days than Caucasians (3.07 vs 2.34 days, P < .001).

Conclusions: African-American and Hispanic children present more often with perforation. Adjusting for perforation, they were more likely to have a complication and longer hospital stays. Access to care and delayed presentations may be potential explanations.

Keywords: Appendicitis; Healthcare disparity; Laparoscopy; Outcomes; Perforation; Race.