Association of Intraoperative Findings With Outcomes and Resource Use in Children With Complicated Appendicitis
Key result
Multiple intraoperative findings in complicated appendicitis are linked to ~60% higher revisit rates versus single findings.
- OR 1.40
- 95% CI 0.95-2.06
- P=.09
- n=1,333
Why the study?
The influence of disease severity on outcomes and health care resource use in children with complicated appendicitis is poorly characterized.
Does the presence of multiple intraoperative findings compared to single findings increase complication rates and resource use in children with complicated appendicitis?
Population
1333 children aged 3 to 18 years with complicated appendicitis undergoing appendectomy
Comparison
Multiple intraoperative findings vs single intraoperative finding of complicated appendicitis
Design
Retrospective cohort study using NSQIP-P and Pediatric Health Information System databases
Authors
Discussion
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Member takes
Implication
Supports heightened surveillance after multiple intraoperative findings in pediatric appendicitis; hypothesis-generating for severity-stratified protocols.
Study Design
Type
Cohort (n=1,333)
Multicenter
Yes
Structured PICO
Does the presence of multiple intraoperative findings compared to single findings increase complication rates and resource use in children with complicated appendicitis?
P
Population
1,333 children aged 3 to 18 years with complicated appendicitis who underwent an appendectomy across 22 hospitals.
E
Exposure
Presence of multiple intraoperative findings of complicated appendicitis (visible hole, fibropurulent exudate in >2 quadrants, abscess, or extraluminal fecalith)
C
Comparator
Presence of a single intraoperative finding of complicated appendicitis
O
Outcome
Thirty-day postoperative adverse event rate, revisit rate, hospital cost, and length of stay
Main Result
Odds Ratio: 1.4 (95% CI 0.95–2.06)
p-value: p=.09
More severe presentations of complicated appendicitis, indicated by multiple intraoperative findings, are significantly associated with worse clinical outcomes and greater resource utilization in children.
Cite This Study
Anandalwar et al. (2018) conducted a cohort in complicated appendicitis (n=1,333). Multiple intraoperative findings vs. Single intraoperative finding was evaluated on surgical site infection (OR 1.40, 95% CI 0.95-2.06, p=.09). Multiple intraoperative findings in complicated appendicitis were associated with higher revisit rates (OR 1.60; 95% CI 1.15-2.21; P=.005) and resource use compared to single findings.