Neighborhood Factors Tied to Delayed Presentation for Pediatric Appendicitis

Girl-lying-in-pain-in-bed-appendicitis
The girl has a stomach ache. She feels bad and uncomfortable, then that it hurts. She holds her hands in her sore spot.
Children from lower-opportunity neighborhoods have higher odds of presenting with complicated appendicitis.

HealthDay News Children from lower-opportunity neighborhoods have higher odds of presenting with complicated appendicitis, according to a study published online Feb. 16 in JAMA Network Open.

Megan E. Bouchard, MD, from the Ann & Robert H. Lurie Children’s Hospital of Chicago, and colleagues examined the association between neighborhood factors and the odds of presenting with complicated appendicitis and unplanned postdischarge health care use. The analysis included 67,489 youth (aged 18 years and younger) diagnosed with appendicitis between Oct. 1, 2015, and Sept. 30, 2018.

The researchers found that 46.3% of cases were complicated. Patients living in neighborhoods with very low Child Opportunity Index (COI) scores had higher odds of presenting with complicated appendicitis (odds ratio, 1.28) versus those in very high-COI neighborhoods. Findings persisted after controlling for patient-level social determinants of health factors. There was no association noted between COI level and unplanned postdischarge health care use (very high COI: 20.8%; very low COI: 19.1%).

“After controlling for patient-level social determinants of health, children from lower-opportunity neighborhoods had 5% to 28% increased odds of presenting with complicated appendicitis, an indicator of delayed access, compared with those from higher-opportunity neighborhoods,” the authors write.

Abstract/Full Text