Racial and Socioeconomic Disparity in Perforated Appendicitis Among Children: Where Is the Problem?

Significant racial, ethnic, and socioeconomic disparities have been observed in the rates of perforated appendicitis among children, by using large administrative databases. This study evaluated whether these factors had an impact on the care of patients with appendicitis at a major children's hospital with a well-established, comprehensive, primary referral system. A retrospective analysis was performed for all children between the ages of 2 and 20 years who were treated for appendicitis between January 1, 2001, and December 31, 2003. Demographic variables included patient age, gender, race, insurance status, parental educational status, and income level. Coding data were used to identify patients with perforated appendicitis. The use of radiologic imaging was also analyzed. During the 3-year period, 788 patients were treated for appendicitis. The racial distribution (white: 81%; black: 12%; other: 7%) was consistent with the demographic composition of the local population. The overall perforation rate was 25%, and the rate was significantly greater in the age group of