Appendicitis in children: a comparative study between a specialist paediatric centre and a district general hospital

Abstract

Purpose The study aimed to compare paediatric appendicectomy practice in a specialist paediatric centre (SPC) with a district general hospital (DGH). Methods This was a retrospective study of children younger than 16 years treated between January 1, 2005, and September 30, 2007. Results Two hundred seven patients (SPC) and 264 (DGH) had an operation for suspected appendicitis. Thirty-one percent of SPC patients were female vs 41% in the DGH ( P = .03). Median age (range) was 10.3 years (1.2-15.9 years) in the SPC and 11.8 (3.3-16.0 years) in the DGH ( P ≤ .0001). The negative appendicectomy rate was 4% at the SPC and 20% at the DGH ( P ≤ .0001). Perforated appendicitis was found in 37% of children at the SPC compared with only 18% at the DGH ( P ≤ .0001). Median (range) length of stay was 5 days at the SPC (1-21 days) compared with 2 days at the DGH (1-21 days) ( P ≤ .0001). Conclusion Our findings have important implications for local practice in our 2 centres but may also have wider implications for the national organisation of the surgical care of children and for the training of general surgeons.