Pediatric patients transferred for operative management of appendicitis: are they at a disadvantage?
PURPOSE
Many pediatric patients are initially diagnosed with appendicitis at referring hospitals and are subsequently transferred to pediatric facilities. We aimed to compare outcomes of patients transferred to a pediatric referral center to those who present primarily for operative management of appendicitis.


METHODS
A retrospective review of 326 patients with operative appendicitis from July 2012 to July 2013 was performed. Demographic data, clinical parameters, and outcomes were analyzed.


RESULTS
Transferred (n=222, 68%) and primary patients (n=104, 32%) were similar except for mean age (primary 12.4 vs. transferred 11.2 years, p<0.01). Computed tomography scans were performed in 80% of transferred compared to 40% of primary patients. Primary patients were more likely to present between the hours of 09:00 and 17:59 (52%), while transferred arrived equally across all hours. Both groups were more likely to present with acute appendicitis (primary 56% vs. transfer 61%, p=NS). There was no difference in time of diagnosis to time of appendectomy, length of hospital stay, or 30 day complications (primary 8.6% vs. transfer 5.8%, p=NS).


CONCLUSIONS
Patients transferred for definitive care of appendicitis are not found to have more advanced disease or have increased complications; however, they are exposed to significantly more ionizing radiation during evaluation for appendicitis.
['Farach|Sandra M|SM|', 'Danielson|Paul D|PD|', 'Walford|N Elizabeth|NE|', 'Harmel|Richard P|RP|', 'Chandler|Nicole M|NM|']
D000208:Acute Disease D000293:Adolescent D001062:Appendectomy D001064:Appendicitis D002648:Child D002675:Child, Preschool D005260:Female D006801:Humans D007223:Infant D007902:Length of Stay D008297:Male D010360:Patient Transfer D012017:Referral and Consultation D012189:Retrospective Studies D014057:Tomography, X-Ray Computed D016896:Treatment Outcome D055815:Young Adult
Pediatric Transfer Appendicitis Appendectomy