Increased complications after appendectomy in patients with cerebral palsy: Are special needs patients at risk for disparities in outcomes?

Background Cerebral palsy (CP) is a nonprogressive neurologic disorder. Anecdotal evidence suggests there are worse outcomes in this population after common operative procedures like appendectomy. This study aims to classify whether there are relevant disparities in postoperative outcomes in CP vers...

Full description

Saved in:
Bibliographic Details
Published in:Surgery 2013-09, Vol.154 (3), p.479-485
Main Authors: Dhiman, Nitasha, MSPH, Chi, Albert, MD, Pawlik, Timothy M., MD, MPH, Efron, David T., MD, Haut, Elliott R., MD, Schneider, Eric B., PhD, Hashmi, Zain G., MBBS, Scott, Valerie K., MSPH, Hui, Xuan, MD, ScM, Ali, Mays T., BS, Haider, Adil H., MD, MPH
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Appendectomy - adverse effects
Cerebral Palsy - complications
Child
Child, Preschool
Comorbidity
Female
Health Status Disparities
Humans
Infant
Infant, Newborn
Logistic Models
Male
Middle Aged
Postoperative Complications - epidemiology
Surgery
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Background Cerebral palsy (CP) is a nonprogressive neurologic disorder. Anecdotal evidence suggests there are worse outcomes in this population after common operative procedures like appendectomy. This study aims to classify whether there are relevant disparities in postoperative outcomes in CP versus non-CP patients after open or laparoscopic appendectomy. Methods Hospital discharge data from the 2003–2009 weighted Nationwide Inpatient Sample were used. Unadjusted and adjusted multiple logistic regression were used to assess postoperative complications, as well as inpatient mortality, average duration of hospital stay, and cost. Results Approximately 1,250 patients with CP met the inclusion criteria. After adjusted analysis, CP patients displayed significantly greater odds of the following postoperative complications: Sepsis/organ failure, operation-related infection, pneumonia, urinary tract infection, and acute respiratory distress syndrome. Patients with CP also had a greater cost and in-hospital stay after appendectomy. Conclusion Patients with CP have greater adjusted odds of complications after open or laparoscopic appendectomy. The mechanisms that led to these disparities need to be studied and may include difficulties in patient assessment and communication. Additional education of healthcare providers to improve recognition of symptoms and care for patients with disabilities may be more immediately helpful in decreasing disparities in outcomes.
ISSN:0039-6060
1532-7361
DOI:10.1016/j.surg.2013.05.038