Background
Appendicitis is the most common operative disease in children, yet few data exist
to support specialized care for childhood appendicitis. We hypothesized that children
treated with specialized care are younger, have more severe disease, and experience
equal or better outcomes.
Methods
Texas Blue Cross/Blue Shield claims data were reviewed for all children <18 years
who underwent appendectomy for acute appendicitis from 2008 to 2012. Primary outcomes
included adverse events, 30-day readmissions, and hospital duration of stay. χ2, Fisher exact test, Student t test, and multivariate regression were performed.
Results
Of the 3,886 pediatric appendectomies, 894 (23%) were performed by pediatric surgeons
and 1,558 (40%) were performed in children's hospitals. Children treated by pediatric
surgeons were younger, had more severe disease, underwent fewer computed tomography
(CT) examinations, and were hospitalized longer (all P < .05). Similarly, children treated in children's hospitals were younger, underwent
fewer CTs, were more likely to undergo laparoscopic appendectomy, and were hospitalized
longer (all P < .05). Specialized care did not predict adverse events or 30-day readmissions; however,
specialized care was associated with longer duration of stay (P < .01).
Conclusion
Privately insured children in Texas treated for appendicitis by pediatric surgeons
or in children's hospitals were younger, had more severe disease, and were hospitalized
longer but were less likely to undergo preoperative CT.
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Article info
Publication history
Published online: June 23, 2015
Accepted:
May 18,
2015
Identification
Copyright
© 2015 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
