Study reports racial disparities in pediatric appendicitis treatment tied to hospital type

http://www.eurekalert.org/pub_releases/2012-12/acos-srr122812.php

Public release date: 28-Dec-2012
Contact: Sally Garneski
American College of Surgeons

Study authors explain that findings published in Journal of American College of Surgeons point to the need for further research on why these racial disparities exist and what preventive interventions can be developed

CHICAGO (December 28, 2012): When researchers from UCLA Medical Center investigated the link between racial disparities and appendicitis outcomes in children, they found that the type of hospital in which black, Hispanic and other minority patients receive care—community, children's or county—affects their odds of developing a perforated appendix. The study published in the January issue of the Journal of the American College of Surgeons is a first-of-its-kind look at the role hospital type plays in race-based treatment variances among this patient subset.

-----

"Appendicitis is a time-dependent disease process that leads to more a complicated medical outcome, and that outcome, perforated appendicitis, has increased hospital costs and increased burden to both the patient and society," according to study author Stephen Shew, MD, FACS, associate professor of surgery, UCLA Medical Center, and a pediatric surgeon at Mattel Children's hospital, both in Los Angeles.

-----

After accounting for age, income level and other known factors that increase risk for a perforated appendix, researchers found that at community hospitals, Hispanic children were 23 percent more likely to experience appendix perforation than white children, and Asian children were 34 percent more likely than white children to experience appendix perforation. Further, Hispanic patients treated at children's hospitals were 18 percent more likely to develop this complication than white patients. Odds of appendix perforation did not differ by race within county hospitals. Researchers also found that black patients treated at children's and county hospitals had a higher risk of appendix perforation compared with black patients treated at community hospitals.

-----

Dr. Shew stressed that further research is still needed on a variety of issues, including whether there is a link between language barriers and understanding symptoms of appendicitis and access to care. "We don't know what explains these findings; however we suspect that there are some other barriers in play," Dr. Shew said. This discovery shows that a critical piece of the puzzle—what is happening with the child and the parents from the time they first discover the symptoms of appendicitis to the time they seek care—is still missing.

-----