Ethnic disparities in children with acute appendicitis

Abstract

Abstract Purpose: Our study assesses if Hispanic children with acute appendicitis experience a more complicated hospital course than non-Hispanic children. Methods: We conducted a retrospective analysis of pediatric patients undergoing appendectomy for acute appendicitis from 2015-2020 using the National Surgical Quality Improvement Program-Pediatric database. Hispanic were compared to non-Hispanic white patients. Results: 65,976 patients were included, of which 23,462 (35.56%) were Hispanic and 42,514 (64.44 %) non-Hispanic white. Hispanic children were more likely to present to the hospital with complicated appendicitis (31.75% vs 25.15%,P<0.0001) and sepsis (25.22% vs 19.02%,P <0.0001) compared to non-Hispanic white. Hispanics had higher rates of serious complications (4.06% vs 3.55%,P=0.001) but not overall complications (5.37% vs 5.09%,P=0.12). However, after multivariate analysis, Hispanic ethnicity was not associated with an increased rate of serious postoperative complications (OR 0.93, CI 0.85-1.01,P=0.088); it was associated with less overall complications (OR 0.88, CI 0.81-0.96,P=0.003) but a longer postoperative length of stay (OR 1.09, CI 1.04-1.14,P<0.0001). Conclusion: Hispanic children are more likely to present with complicated appendicitis. This leads to increased postoperative complications in Hispanic children. After adjusting for complicated appendicitis, outcomes may be favorable for Hispanic ethnicity. This emphasizes the need to understand delays in presentation to improve outcomes in the Hispanic population. Level of evidence: III