title: The effect of race on outcomes for appendicitis in children: a nationwide analysis.
abstract: BACKGROUND
  We sought to examine the impact of race on the management and outcomes of appendicitis in children aged 20 years or younger.
  
  
  METHODS
  We studied 96,865 inpatient admissions for children undergoing an appendectomy for acute appendicitis in 2009 using the Kids' Inpatient Database.
  
  
  RESULTS
  Perforation at presentation was more common among African-Americans and Hispanics than Caucasians (27.5% and 32.5%, respectively, vs 23.9%, P < .001). African-Americans were less likely to have a laparoscopic procedure (odds ratio [OR]: .839, P < .001) and more likely to experience a complication (OR: 1.753, P < .001). Hispanics were also more likely to have a complication (OR: 1.123, P = .001). African-Americans and Hispanics remained in the hospital for .73 more days than Caucasians (3.07 vs 2.34 days, P < .001).
  
  
  CONCLUSIONS
  African-American and Hispanic children present more often with perforation. Adjusting for perforation, they were more likely to have a complication and longer hospital stays. Access to care and delayed presentations may be potential explanations.
authors.affiliation: Department of Surgery, Madigan Army Medical Center, Tacoma, WA 98431, USA. Electronic address: npzwintscher@gmail.com.
authors.forename: Nathan P
authors.initials: NP
authors.lastname: Zwintscher
authors.affiliation: Department of Surgery, Madigan Army Medical Center, Tacoma, WA 98431, USA.
authors.forename: Scott R
authors.initials: SR
authors.lastname: Steele
authors.affiliation: Department of Surgery, Madigan Army Medical Center, Tacoma, WA 98431, USA.
authors.forename: Matthew J
authors.initials: MJ
authors.lastname: Martin
authors.affiliation: Department of Surgery, Children's Hospital & Research Center, Oakland, CA, USA.
authors.forename: Christopher R
authors.initials: CR
authors.lastname: Newton
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D001741:Black or African American; D001062:Appendectomy / Q000379:methods; D001064:Appendicitis / Q000208:ethnology* / Q000601:surgery; D001213:Asian; D002648:Child; D002675:Child, Preschool; D016208:Databases, Factual; D005260:Female; D054625:Healthcare Disparities / Q000208:ethnology*; D006630:Hispanic or Latino; D006801:Humans; D007198:Indians, North American; D007223:Infant; D007231:Infant, Newborn; D010535:Laparoscopy; D007902:Length of Stay; D016015:Logistic Models; D008297:Male; D016017:Odds Ratio; D011183:Postoperative Complications / Q000208:ethnology*; D016896:Treatment Outcome; D014481:United States; D044465:White People; D055815:Young Adult
keywords: Appendicitis; Healthcare disparity; Laparoscopy; Outcomes; Perforation; Race