A. A. Desai1, K. W. Schnell1, B. G. Dalton1, S. D. St. Peter1, C. L. Snyder1 1Children’s Mercy Hospital- University Of Missouri Kansas City,Kansas City, MO, USA
Introduction: Seasonal variation in the incidence of acute appendicitis has been recognized. The aim of this study was to determine whether children with non-perforated and perforated appendicitis were more likely to present during specific days of the week or seasons of the year in the United States. Previously reported data demonstrates increased likelihood of presentation of perforated appendicitis on Mondays and increased rates of presentation during the fall and winter.
Methods: A retrospective population-based study of patients was performed by querying The Pediatric Health Information System (PHIS) database over a 9-year period for de-identified patients with both ICD-9 code for appendicitis and procedure code for appendectomy. Patients greater than 18 years of age were excluded. Demographics and temporal data regarding day, quarter, and month were based on day of operation. Chi square and odds ratio were performed where appropriate.
Results: A total of 139,499 children were admitted during the study interval of which 34.1% were perforated. The greatest incidence for non-perforated appendicitis was Tuesday (15.9%), and the greatest incidence for perforated appendicitis was Monday (15.8%). Although the greatest incidence of perforated appendicitis was on Monday, this was not significant (p=0.72). The weekends however were at higher odds (OR: 1.13; 95% CI1.102-1.16) for perforation. Peak incidence of non-perforated appendicitis occurs in the summer (spring 25.9%, summer 27.1%, autumn: 23.8%, winter: 23.1%). Peak presentation of perforated appendicitis occurs in the summer as well (spring: 8.8%, summer: 9.2%, autumn: 8.1%, winter: 7.9%) However, the odds of perforated appendicitis during summer months (OR: 1, CI: 0.97-1.02) or winter months (OR 1.0, CI: 0.99-1.05) was not significant.
Conclusion: Presentation with perforated appendicitis is more likely to occur on the weekends. Seasonal variation supports previously reported data demonstrating peak presentation of non-perforated and perforated appendicitis in the summer, however increased odds of perforation in fall and winter months was not noted in this study.