Lack of access to pediatricians could mean life-threatening appendix ruptures in children. Surgeons, hospitals, imaging technology or insurance coverage, none of them can compensate inadequate pediatric care, according to a study from the Johns Hopkins Childrens Center.
The studys findings, based on an analysis of nearly 250,000 hospital records of children with appendicitis, are published online in the December issue of JAMA-
Archives of Surgery.
Our analysis shows that the most potent predictor of outcome in children with appendicitis was the number of pediatricians available in an area, emphasizing the pivotal role they play as the point of first contact in the care of a sick child, said lead investigator Fizan Abdullah, M.D., Ph.D., a pediatric surgeon at the Johns Hopkins Childrens Center.
The appendix is a small tube extending from the large intestine, and infections and inflammation of the organ can be dangerous. Each year, 77,000 children develop appendicitis, and an estimated one-third of them suffer a ruptured appendix, a serious complication that often results from delays in diagnosis and surgery to remove the inflamed or infected organ.
The analysis showed that children with appendicitis living in counties with the most pediatricians per capita were the least likely to develop complications, and the more pediatricians in a geographic area, the fewer the instances of ruptured appendix. For every 100 children with appendicitis, 12 more children (12 percent more) would end up with ruptured appendix in the area with the fewest pediatricians than in the area with the most pediatricians.