| Appendicitis in northern aboriginal children: does delay in definitive treatment affect outcome? | |
| | |
MedLine Citation:
|
PMID: 20438920 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
BACKGROUND: The treatment of northern aboriginal children (NAC) is often complicated by distance from a treating facility. We sought to compare outcomes of NAC requiring transfer with appendicitis to those who presented locally. We hypothesized that NAC with appendicitis experienced higher rates of perforation and increased length of stay (LOS). METHODS: A retrospective chart review of 210 appendectomies was performed. Charts were reviewed for age, sex, weight, days of symptoms before presentation, time of transfer, leukocyte count (white blood cell count), usage of antibiotics prior to transfer, time to operation, type of procedure and findings, pathology, postoperative outcomes, and LOS. RESULTS: Sixty-eight children were NAC, whereas 142 were local. The average transfer times for NAC was 10 hours (range, 4-20 hours). The two groups had similar ages (11.1 vs 10.7 years), time to presentation (1.64 vs 1.85 days), and LOS (2.91 vs 2.90 days). Significantly higher perforation rates (44 vs 28%; P = .02), higher white blood cell count (17.9 vs 16.0; P = .02), and longer times to operation after arrival (10.3 vs 7.0 hours; P = .0002) were noted in NAC. Postoperative complications were similar between groups. Forty-seven (69%) NAC received antibiotics prior to transfer, which did not affect rate of rupture. CONCLUSION: NAC with appendicitis experience longer transfer times and higher perforation rates than local children without a difference in length of stay or complications. Pretransfer antibiotics do not reduce perforation rates but may impact complications. We endorse their use if a delay in transfer is anticipated. |
| | |
Authors:
|
Alana Beres; Saleh Al-Abbad; Pramod S Puligandla |
Publication Detail:
|
Type: Comparative Study; Journal Article |
Journal Detail:
|
Title: Journal of pediatric surgery Volume: 45 ISSN: 1531-5037 ISO Abbreviation: J. Pediatr. Surg. Publication Date: 2010 May |
Date Detail:
|
Created Date: 2010-05-04 Completed Date: 2010-08-04 Revised Date: - |
Medline Journal Info:
|
Nlm Unique ID: 0052631 Medline TA: J Pediatr Surg Country: United States |
Other Details:
|
Languages: eng Pagination: 890-3 Citation Subset: IM |
Copyright Information:
|
Copyright (c) 2010 Elsevier Inc. All rights reserved. |
Affiliation:
|
Division of Pediatric General Surgery, The Montreal Children's Hospital of the McGill University Health Centre, Montreal, Quebec, Canada H3H1P3. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
American Native Continental Ancestry Group* Appendectomy* Appendicitis / surgery* Child Humans Patient Transfer* Postoperative Complications Quebec Retrospective Studies Survival Analysis Time Factors Treatment Outcome |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Correlation of complex ascites with intestinal gangrene and perforation in neonates with necrotizing...
Next Document: Comparison of pediatric appendicitis outcomes between teaching and nonteaching hospitals.