Management and outcomes of acute appendicitis in children with congenital heart disease
Background Congenital heart disease (CHD) care has evolved during the past decades. Advances in care have contributed to improved survival among CHD patients. Children with CHD are requiring interventions for non-CHD related medical issues that occur in the general pediatric population. Methods A re...
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| Veröffentlicht in: | Pediatric surgery international 2024-10, Vol.40 (1), p.273, Article 273 |
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| creator | O’Connor, Mario Well, Andrew Morgan, Joshua Liu, Michael Y. Josephs, Michael D. Venardos, Neil M. Fraser, Charles D. Mery, Carlos M. |
| description | Background
Congenital heart disease (CHD) care has evolved during the past decades. Advances in care have contributed to improved survival among CHD patients. Children with CHD are requiring interventions for non-CHD related medical issues that occur in the general pediatric population.
Methods
A retrospective review of the Pediatric Health Information System (PHIS) database from January 1, 2004, to July 31, 2023. Discharges of patients with an admitting/principal diagnosis of appendicitis were evaluated and categorized as CHD or non-CHD.
Results
A total of 319,228 patients were identified with 1,25,858(39.4%) female, 1,38,966(43.5%) white, and median age of 11[IQR:8–14] years. 708(0.2%) had CHD with 85(12%) of them having a diagnosis consistent with single-ventricle CHD (SV-CHD). In univariate analysis, CHD patients were more likely to undergo conservative treatment (n = 172(24.2%)vs n = 59,358(18.6%)) and less likely to undergo laparoscopic appendectomy (n = 483(68.2%) vs n = 2,35,324(73.8%))(p |
| doi_str_mv | 10.1007/s00383-024-05864-0 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_3120594335</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>3120594335</sourcerecordid><originalsourceid>FETCH-LOGICAL-c256t-1d3ea5d2d1bd73aa806b4b972065bd957772cb3aa6aff55e662d2f98a07835e33</originalsourceid><addsrcrecordid>eNp9kMFO3DAQhq2KqrtAX4BDZakXLoGJHTvJESFokUBcQBwtx56wRomz2I4Qb4-7u6WoBy7jkeabf6yPkKMSTkqA-jQC8IYXwKoCRCNz_UKWZcXrom1KvvehX5D9GJ8AoOGy_UYWvK2qhrdiSR5utNePOKJPVHtLpzmZacRIp55qMyeker1Gb51xyUXqPDUrN9iAnr64tKJm8o_oXdIDXaEOiVoXUUc8JF97PUT8vnsPyP3lxd357-L69tfV-dl1YZiQqSgtRy0ss2Vna651A7KrurZmIEVnW1HXNTNdHkjd90KglMyyvm001A0XyPkBOd7mrsP0PGNManTR4DBoj9McFS8ZiLbiXGT053_o0zQHn3-3ofJJEDJTbEuZMMUYsFfr4EYdXlUJ6o92tdWusna10a4gL_3YRc_diPZ95a_nDPAtEPMoGwv_bn8S-wZFro1E</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>3120206056</pqid></control><display><type>article</type><title>Management and outcomes of acute appendicitis in children with congenital heart disease</title><source>MEDLINE</source><source>SpringerLink Journals - AutoHoldings</source><creator>O’Connor, Mario ; Well, Andrew ; Morgan, Joshua ; Liu, Michael Y. ; Josephs, Michael D. ; Venardos, Neil M. ; Fraser, Charles D. ; Mery, Carlos M.</creator><creatorcontrib>O’Connor, Mario ; Well, Andrew ; Morgan, Joshua ; Liu, Michael Y. ; Josephs, Michael D. ; Venardos, Neil M. ; Fraser, Charles D. ; Mery, Carlos M.</creatorcontrib><description>Background
Congenital heart disease (CHD) care has evolved during the past decades. Advances in care have contributed to improved survival among CHD patients. Children with CHD are requiring interventions for non-CHD related medical issues that occur in the general pediatric population.
Methods
A retrospective review of the Pediatric Health Information System (PHIS) database from January 1, 2004, to July 31, 2023. Discharges of patients with an admitting/principal diagnosis of appendicitis were evaluated and categorized as CHD or non-CHD.
Results
A total of 319,228 patients were identified with 1,25,858(39.4%) female, 1,38,966(43.5%) white, and median age of 11[IQR:8–14] years. 708(0.2%) had CHD with 85(12%) of them having a diagnosis consistent with single-ventricle CHD (SV-CHD). In univariate analysis, CHD patients were more likely to undergo conservative treatment (n = 172(24.2%)vs n = 59,358(18.6%)) and less likely to undergo laparoscopic appendectomy (n = 483(68.2%) vs n = 2,35,324(73.8%))(p < 0.001) compared to non-CHD. After adjustment, CHD patients had increased odds of undergoing open appendectomy compared to non-CHD. CHD patients were more likely to have an ICU admission (OR:8.36(95%CI 6.35–10.00),p < 0.001) and had a 77.6%(95%CI 40.89–123.93) increase in length of stay (LOS) (p < 0.001).
Conclusion
CHD patients are more likely to have an open appendectomy than non-CHD patients. These findings suggest a distinctive pattern in the care of CHD patients compared to non-CHD. Overall, CHD patients had a more intense level of care with longer LOS and increased ICU admissions. Further work is needed to evaluate drivers of management decisions, the role of conservative treatment with antibiotics alone in the CHD population, and the potential impacts and safety of a laparoscopic approach.</description><identifier>ISSN: 1437-9813</identifier><identifier>ISSN: 0179-0358</identifier><identifier>EISSN: 1437-9813</identifier><identifier>DOI: 10.1007/s00383-024-05864-0</identifier><identifier>PMID: 39448395</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Acute Disease ; Adolescent ; Appendectomy ; Appendectomy - methods ; Appendicitis ; Appendicitis - complications ; Appendicitis - surgery ; Cardiovascular disease ; Child ; Congenital diseases ; Female ; Heart Defects, Congenital - complications ; Heart Defects, Congenital - surgery ; Humans ; Laparoscopy ; Laparoscopy - methods ; Length of Stay - statistics & numerical data ; Male ; Medicine ; Medicine & Public Health ; Pediatric Surgery ; Pediatrics ; Retrospective Studies ; Review ; Surgery ; Treatment Outcome</subject><ispartof>Pediatric surgery international, 2024-10, Vol.40 (1), p.273, Article 273</ispartof><rights>The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature 2024 Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.</rights><rights>2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.</rights><rights>Copyright Springer Nature B.V. Dec 2024</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c256t-1d3ea5d2d1bd73aa806b4b972065bd957772cb3aa6aff55e662d2f98a07835e33</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00383-024-05864-0$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00383-024-05864-0$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/39448395$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>O’Connor, Mario</creatorcontrib><creatorcontrib>Well, Andrew</creatorcontrib><creatorcontrib>Morgan, Joshua</creatorcontrib><creatorcontrib>Liu, Michael Y.</creatorcontrib><creatorcontrib>Josephs, Michael D.</creatorcontrib><creatorcontrib>Venardos, Neil M.</creatorcontrib><creatorcontrib>Fraser, Charles D.</creatorcontrib><creatorcontrib>Mery, Carlos M.</creatorcontrib><title>Management and outcomes of acute appendicitis in children with congenital heart disease</title><title>Pediatric surgery international</title><addtitle>Pediatr Surg Int</addtitle><addtitle>Pediatr Surg Int</addtitle><description>Background
Congenital heart disease (CHD) care has evolved during the past decades. Advances in care have contributed to improved survival among CHD patients. Children with CHD are requiring interventions for non-CHD related medical issues that occur in the general pediatric population.
Methods
A retrospective review of the Pediatric Health Information System (PHIS) database from January 1, 2004, to July 31, 2023. Discharges of patients with an admitting/principal diagnosis of appendicitis were evaluated and categorized as CHD or non-CHD.
Results
A total of 319,228 patients were identified with 1,25,858(39.4%) female, 1,38,966(43.5%) white, and median age of 11[IQR:8–14] years. 708(0.2%) had CHD with 85(12%) of them having a diagnosis consistent with single-ventricle CHD (SV-CHD). In univariate analysis, CHD patients were more likely to undergo conservative treatment (n = 172(24.2%)vs n = 59,358(18.6%)) and less likely to undergo laparoscopic appendectomy (n = 483(68.2%) vs n = 2,35,324(73.8%))(p < 0.001) compared to non-CHD. After adjustment, CHD patients had increased odds of undergoing open appendectomy compared to non-CHD. CHD patients were more likely to have an ICU admission (OR:8.36(95%CI 6.35–10.00),p < 0.001) and had a 77.6%(95%CI 40.89–123.93) increase in length of stay (LOS) (p < 0.001).
Conclusion
CHD patients are more likely to have an open appendectomy than non-CHD patients. These findings suggest a distinctive pattern in the care of CHD patients compared to non-CHD. Overall, CHD patients had a more intense level of care with longer LOS and increased ICU admissions. Further work is needed to evaluate drivers of management decisions, the role of conservative treatment with antibiotics alone in the CHD population, and the potential impacts and safety of a laparoscopic approach.</description><subject>Acute Disease</subject><subject>Adolescent</subject><subject>Appendectomy</subject><subject>Appendectomy - methods</subject><subject>Appendicitis</subject><subject>Appendicitis - complications</subject><subject>Appendicitis - surgery</subject><subject>Cardiovascular disease</subject><subject>Child</subject><subject>Congenital diseases</subject><subject>Female</subject><subject>Heart Defects, Congenital - complications</subject><subject>Heart Defects, Congenital - surgery</subject><subject>Humans</subject><subject>Laparoscopy</subject><subject>Laparoscopy - methods</subject><subject>Length of Stay - statistics & numerical data</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Pediatric Surgery</subject><subject>Pediatrics</subject><subject>Retrospective Studies</subject><subject>Review</subject><subject>Surgery</subject><subject>Treatment Outcome</subject><issn>1437-9813</issn><issn>0179-0358</issn><issn>1437-9813</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kMFO3DAQhq2KqrtAX4BDZakXLoGJHTvJESFokUBcQBwtx56wRomz2I4Qb4-7u6WoBy7jkeabf6yPkKMSTkqA-jQC8IYXwKoCRCNz_UKWZcXrom1KvvehX5D9GJ8AoOGy_UYWvK2qhrdiSR5utNePOKJPVHtLpzmZacRIp55qMyeker1Gb51xyUXqPDUrN9iAnr64tKJm8o_oXdIDXaEOiVoXUUc8JF97PUT8vnsPyP3lxd357-L69tfV-dl1YZiQqSgtRy0ss2Vna651A7KrurZmIEVnW1HXNTNdHkjd90KglMyyvm001A0XyPkBOd7mrsP0PGNManTR4DBoj9McFS8ZiLbiXGT053_o0zQHn3-3ofJJEDJTbEuZMMUYsFfr4EYdXlUJ6o92tdWusna10a4gL_3YRc_diPZ95a_nDPAtEPMoGwv_bn8S-wZFro1E</recordid><startdate>20241024</startdate><enddate>20241024</enddate><creator>O’Connor, Mario</creator><creator>Well, Andrew</creator><creator>Morgan, Joshua</creator><creator>Liu, Michael Y.</creator><creator>Josephs, Michael D.</creator><creator>Venardos, Neil M.</creator><creator>Fraser, Charles D.</creator><creator>Mery, Carlos M.</creator><general>Springer Berlin Heidelberg</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope></search><sort><creationdate>20241024</creationdate><title>Management and outcomes of acute appendicitis in children with congenital heart disease</title><author>O’Connor, Mario ; Well, Andrew ; Morgan, Joshua ; Liu, Michael Y. ; Josephs, Michael D. ; Venardos, Neil M. ; Fraser, Charles D. ; Mery, Carlos M.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c256t-1d3ea5d2d1bd73aa806b4b972065bd957772cb3aa6aff55e662d2f98a07835e33</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Acute Disease</topic><topic>Adolescent</topic><topic>Appendectomy</topic><topic>Appendectomy - methods</topic><topic>Appendicitis</topic><topic>Appendicitis - complications</topic><topic>Appendicitis - surgery</topic><topic>Cardiovascular disease</topic><topic>Child</topic><topic>Congenital diseases</topic><topic>Female</topic><topic>Heart Defects, Congenital - complications</topic><topic>Heart Defects, Congenital - surgery</topic><topic>Humans</topic><topic>Laparoscopy</topic><topic>Laparoscopy - methods</topic><topic>Length of Stay - statistics & numerical data</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Pediatric Surgery</topic><topic>Pediatrics</topic><topic>Retrospective Studies</topic><topic>Review</topic><topic>Surgery</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>O’Connor, Mario</creatorcontrib><creatorcontrib>Well, Andrew</creatorcontrib><creatorcontrib>Morgan, Joshua</creatorcontrib><creatorcontrib>Liu, Michael Y.</creatorcontrib><creatorcontrib>Josephs, Michael D.</creatorcontrib><creatorcontrib>Venardos, Neil M.</creatorcontrib><creatorcontrib>Fraser, Charles D.</creatorcontrib><creatorcontrib>Mery, Carlos M.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>Pediatric surgery international</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>O’Connor, Mario</au><au>Well, Andrew</au><au>Morgan, Joshua</au><au>Liu, Michael Y.</au><au>Josephs, Michael D.</au><au>Venardos, Neil M.</au><au>Fraser, Charles D.</au><au>Mery, Carlos M.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Management and outcomes of acute appendicitis in children with congenital heart disease</atitle><jtitle>Pediatric surgery international</jtitle><stitle>Pediatr Surg Int</stitle><addtitle>Pediatr Surg Int</addtitle><date>2024-10-24</date><risdate>2024</risdate><volume>40</volume><issue>1</issue><spage>273</spage><pages>273-</pages><artnum>273</artnum><issn>1437-9813</issn><issn>0179-0358</issn><eissn>1437-9813</eissn><abstract>Background
Congenital heart disease (CHD) care has evolved during the past decades. Advances in care have contributed to improved survival among CHD patients. Children with CHD are requiring interventions for non-CHD related medical issues that occur in the general pediatric population.
Methods
A retrospective review of the Pediatric Health Information System (PHIS) database from January 1, 2004, to July 31, 2023. Discharges of patients with an admitting/principal diagnosis of appendicitis were evaluated and categorized as CHD or non-CHD.
Results
A total of 319,228 patients were identified with 1,25,858(39.4%) female, 1,38,966(43.5%) white, and median age of 11[IQR:8–14] years. 708(0.2%) had CHD with 85(12%) of them having a diagnosis consistent with single-ventricle CHD (SV-CHD). In univariate analysis, CHD patients were more likely to undergo conservative treatment (n = 172(24.2%)vs n = 59,358(18.6%)) and less likely to undergo laparoscopic appendectomy (n = 483(68.2%) vs n = 2,35,324(73.8%))(p < 0.001) compared to non-CHD. After adjustment, CHD patients had increased odds of undergoing open appendectomy compared to non-CHD. CHD patients were more likely to have an ICU admission (OR:8.36(95%CI 6.35–10.00),p < 0.001) and had a 77.6%(95%CI 40.89–123.93) increase in length of stay (LOS) (p < 0.001).
Conclusion
CHD patients are more likely to have an open appendectomy than non-CHD patients. These findings suggest a distinctive pattern in the care of CHD patients compared to non-CHD. Overall, CHD patients had a more intense level of care with longer LOS and increased ICU admissions. Further work is needed to evaluate drivers of management decisions, the role of conservative treatment with antibiotics alone in the CHD population, and the potential impacts and safety of a laparoscopic approach.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>39448395</pmid><doi>10.1007/s00383-024-05864-0</doi></addata></record> |
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| subjects | Acute Disease Adolescent Appendectomy Appendectomy - methods Appendicitis Appendicitis - complications Appendicitis - surgery Cardiovascular disease Child Congenital diseases Female Heart Defects, Congenital - complications Heart Defects, Congenital - surgery Humans Laparoscopy Laparoscopy - methods Length of Stay - statistics & numerical data Male Medicine Medicine & Public Health Pediatric Surgery Pediatrics Retrospective Studies Review Surgery Treatment Outcome |
| title | Management and outcomes of acute appendicitis in children with congenital heart disease |
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