Forthcoming Issue Vol 19 No. 4 Profile of Paediatric Patients with Appendicitis at an Academic Hospital After Admission Criteria Change
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Abstract
Background: Appendicitis is the most common surgical emergency in children. During the COVID-19 pandemic, Chris Hani Baragwanath Academic Hospital (CHBAH) raised the cut-off age for paediatric surgery admission from 10 to 14 years due to constraints placed on pre-existing systems during the pandemic. This change resulted in a new profile of appendicitis cases within the department.
Objectives: To describe the profile of paediatric patients with appendicitis at CHBAH following the implementation of an age limit change in admission criteria.
Methods: This retrospective descriptive study reviewed all patients aged ≤14 years who were managed for appendicitis in the Paediatric Surgery Department at CHBAH between July 2020 and June 2023.
Results: A total of 308 patients were included in the study. The mean age at presentation was 9.36 years, with a male-to-female ratio of 1.6:1. Almost half (45.13%) of the patients were over 10 years of age. Of the total patients, over two thirds (69.48%) presented with complicated appendicitis, and almost all (95.13%) underwent surgical management. Compared to patients with uncomplicated appendicitis, those with complicated appendicitis had significantly more post-operative complications (p<0.001), a higher readmission rate (p=0.004), required more re-look procedures (p<0.001), had longer hospital stays (p<0.001), and a higher mortality rate (p<0.001).
Conclusions: This study reveals a concerning prevalence of complicated appendicitis in paediatric patients, highlighting the necessity for prompt diagnosis and intervention. An increased patient load placed strain on paediatric surgery hospital resources, while the pandemic likely worsened treatment delays. Ongoing research is essential for optimising management strategies and improving surgical outcomes.
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