title: Pediatric appendicitis in New England: epidemiology and outcomes.
abstract: BACKGROUND
  Acute appendicitis is among the most common indications for surgery in children in the Western world. The epidemiology of acute appendicitis in the United States has not been recently analyzed in a population-based cohort study.
  
  
  METHODS
  Here, we describe the epidemiology of acute appendicitis in the pediatric population in New England from 2000 to 2006.
  
  
  RESULTS
  Our results show that there is clustering of perforated and nonperforated appendicitis by hospital catchment area (Moran I index 0.01 and 0.03, respectively). The overall incidence of nonperforated appendicitis decreased over our study period by 9.7% (P < .05), the proportion of perforated appendicitis did not change significantly over our study period, and there was a 38% decrease in the proportion of negative appendectomies (P < .05).
  
  
  CONCLUSIONS
  There were trends toward increased operative volume for pediatric surgeons as well as sharp increases in the use of laparoscopy and early discharge with home health services. Our results demonstrate that the epidemiology, outcomes, and trends in treatment of acute appendicitis continue to change.
authors.affiliation: University of Washington, Seattle, WA 98102, USA. shahram@u.washington.edu
authors.forename: Shahram
authors.initials: S
authors.lastname: Aarabi
authors.forename: Feroze
authors.initials: F
authors.lastname: Sidhwa
authors.forename: Kimberly J
authors.initials: KJ
authors.lastname: Riehle
authors.forename: Qiaoli
authors.initials: Q
authors.lastname: Chen
authors.forename: David P
authors.initials: DP
authors.lastname: Mooney
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D017677:Age Distribution; D001062:Appendectomy / Q000379:methods / Q000706:statistics & numerical data*; D001064:Appendicitis / Q000175:diagnosis / Q000453:epidemiology* / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D016001:Confidence Intervals; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D009511:New England / Q000453:epidemiology; D011379:Prognosis; D012189:Retrospective Studies; D012720:Severity of Illness Index; D017678:Sex Distribution; D016896:Treatment Outcome