title: Age at presentation of common pediatric surgical conditions: Reexamining dogma.
abstract: OBJECTIVE
  The commonly cited ages at presentation of many pediatric conditions have been based largely on single center or outdated epidemiologic evidence. Thus, we sought to examine the ages at presentation of common pediatric surgical conditions using cases from large national databases.
  
  
  METHODS
  A retrospective analysis was performed on Healthcare Cost and Utilization Project databases from 1988 to 2009. Pediatric discharges were selected using matched ICD9 diagnosis and procedure codes for malrotation, intussusception, hypertrophic pyloric stenosis (HPS), incarcerated inguinal hernia (IH), and Hirschsprung disease (HD). Descriptive statistics were computed.
  
  
  RESULTS
  A total of 63,750 discharges were identified, comprising 2744 cases of malrotation, 5831 of intussusception, 36,499 of HPS, 8564 of IH, and 10,112 of HD. About 58.2% of malrotation cases presented before age 1. Moreover, 92.8% of HPS presented between 3 and 10weeks. For intussusception, 50.3% and 91.4% presented prior to ages 1 and 4years, respectively. Also, 55.8% of IHD cases presented before their first birthday. For HD, 6.5% of cases presented within the neonatal period and 45.9% prior to age 1year.
  
  
  CONCLUSIONS
  Our findings support generally cited presenting ages for HPS and intussusception. However, the ages at presentation for HD, malrotation, and IH differ from commonly cited texts.
authors.affiliation: Center for Pediatric Surgical Clinical Trials & Outcomes Research, Division of Pediatric Surgery, Johns Hopkins University School of Medicine.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Aboagye
authors.affiliation: Center for Pediatric Surgical Clinical Trials & Outcomes Research, Division of Pediatric Surgery, Johns Hopkins University School of Medicine.
authors.forename: Seth D
authors.initials: SD
authors.lastname: Goldstein
authors.affiliation: Center for Pediatric Surgical Clinical Trials & Outcomes Research, Division of Pediatric Surgery, Johns Hopkins University School of Medicine.
authors.forename: Jose H
authors.initials: JH
authors.lastname: Salazar
authors.affiliation: Center for Pediatric Surgical Clinical Trials & Outcomes Research, Division of Pediatric Surgery, Johns Hopkins University School of Medicine.
authors.forename: Dominic
authors.initials: D
authors.lastname: Papandria
authors.affiliation: Center for Pediatric Surgical Clinical Trials & Outcomes Research, Division of Pediatric Surgery, Johns Hopkins University School of Medicine.
authors.forename: Mekam T
authors.initials: MT
authors.lastname: Okoye
authors.affiliation: Center for Pediatric Surgical Clinical Trials & Outcomes Research, Division of Pediatric Surgery, Johns Hopkins University School of Medicine.
authors.forename: Khaled
authors.initials: K
authors.lastname: Al-Omar
authors.affiliation: Center for Pediatric Surgical Clinical Trials & Outcomes Research, Division of Pediatric Surgery, Johns Hopkins University School of Medicine.
authors.forename: Dylan
authors.initials: D
authors.lastname: Stewart
authors.affiliation: Center for Pediatric Surgical Clinical Trials & Outcomes Research, Division of Pediatric Surgery, Johns Hopkins University School of Medicine.
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Lukish
authors.affiliation: Center for Pediatric Surgical Clinical Trials & Outcomes Research, Division of Pediatric Surgery, Johns Hopkins University School of Medicine. Electronic address: fa@jhmi.edu.
authors.forename: Fizan
authors.initials: F
authors.lastname: Abdullah
mesh_terms: D000293:Adolescent; D017677:Age Distribution; D000367:Age Factors; D017668:Age of Onset; D002648:Child; D002675:Child, Preschool; D004065:Digestive System Abnormalities / Q000453:epidemiology* / Q000601:surgery*; D013505:Digestive System Surgical Procedures; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D015995:Prevalence; D012042:Registries; D012189:Retrospective Studies; D014481:United States / Q000453:epidemiology
keywords: Age at presentation; Hirschsprung disease; Inguinal hernia; Intussusception; Malrotation; Pyloric stenosis