title: Predictors of a Prolonged Length of Stay in Children with Perforated Appendicitis.
abstract: OBJECTIVE
  Little is known about the factors that affect the length of stay (LOS) of children hospitalized for perforated appendicitis. The objective of this study was to identify clinical and demographic factors associated with a prolonged LOS (PLOS) in children with perforated appendicitis.
  
  
  METHODS
  A retrospective cohort study was conducted using the records of 197 children 0 to 17 years old with perforated appendicitis. The children were hospitalized at one of two teaching hospitals located in El Paso, Texas, and were discharged between January 2008 and January 2014. PLOS was defined as an LOS greater than the 75th percentile value in our patient cohort, which was 7 days. An initial log-binomial regression model failed to converge, and hence logistic regression was used to calculate adjusted incidence odds ratios (OR) for PLOS, 95% confidence intervals, P values, and a receiver operating characteristic curve. The best subset method was used to identify predictors for inclusion in the final model.
  
  
  RESULTS
  The overall risk of PLOS was 23.4% (46/197). Approximately 76% of the children who experienced PLOS and 94% of those who did not have PLOS were Hispanic. After adjusting for insurance status, presence of an abscess, asthma, consulting interventional radiology, and various antibiotics, Hispanics were less likely than non-Hispanics to experience PLOS (adjusted OR 0.20; P = 0.003). Children whose providers consulted the interventional radiologist had an increased odds of PLOS (adjusted OR 3.64; P = 0.01).
  
  
  CONCLUSIONS
  Hispanic ethnicity was associated with a lower odds of PLOS, whereas children who required the services of an interventional radiologist were more likely to experience PLOS.
authors.affiliation: From the Departments of Pediatrics and Obstetrics and Gynecology, Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center, El Paso.
authors.forename: Indu S
authors.initials: IS
authors.lastname: Pathak
authors.affiliation: From the Departments of Pediatrics and Obstetrics and Gynecology, Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center, El Paso.
authors.forename: Imran A
authors.initials: IA
authors.lastname: Sayed
authors.affiliation: From the Departments of Pediatrics and Obstetrics and Gynecology, Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center, El Paso.
authors.forename: Laura
authors.initials: L
authors.lastname: Wise
authors.affiliation: From the Departments of Pediatrics and Obstetrics and Gynecology, Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center, El Paso.
authors.forename: Michael
authors.initials: M
authors.lastname: Sippel
authors.affiliation: From the Departments of Pediatrics and Obstetrics and Gynecology, Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center, El Paso.
authors.forename: Loretta L
authors.initials: LL
authors.lastname: Hernandez
authors.affiliation: From the Departments of Pediatrics and Obstetrics and Gynecology, Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center, El Paso.
authors.forename: Zuber D
authors.initials: ZD
authors.lastname: Mulla
mesh_terms: D000293:Adolescent; D001064:Appendicitis / Q000208:ethnology / Q000628:therapy*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006630:Hispanic or Latino; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007902:Length of Stay / Q000706:statistics & numerical data*; D016015:Logistic Models; D008297:Male; D016017:Odds Ratio; D012189:Retrospective Studies; D012307:Risk Factors; D013781:Texas / Q000453:epidemiology