دورية أكاديمية
Demographic and Clinical Characteristics Associated With the Failure of Nonoperative Management of Uncomplicated Appendicitis in Children: Secondary Analysis of a Nonrandomized Clinical Trial
| العنوان: | Demographic and Clinical Characteristics Associated With the Failure of Nonoperative Management of Uncomplicated Appendicitis in Children: Secondary Analysis of a Nonrandomized Clinical Trial |
|---|---|
| المؤلفون: | Minneci, Peter C., Hade, Erinn M., Gil, Lindsay A., Metzger, Gregory A., Saito, Jacqueline M., Mak, Grace Z., Hirschl, Ronald B., Gadepalli, Samir, Helmrath, Michael A., Leys, Charles M., Sato, Thomas T., Lal, Dave R., Landman, Matthew P., Kabre, Rashmi, Fallat, Mary E., Cooper, Jennifer N., Deans, Katherine J., Midwest Pediatric Surgery Consortium |
| المساهمون: | Surgery, School of Medicine |
| المصدر: | PMC |
| بيانات النشر: | JAMA |
| سنة النشر: | 2022 |
| المجموعة: | Indiana University - Purdue University Indianapolis: IUPUI Scholar Works |
| مصطلحات موضوعية: | Anti-bacterial agents, Appendicitis, Pain, Quality of life |
| الوصف: | Importance: The factors associated with the failure of nonoperative management of appendicitis and the differences in patient-reported outcomes between successful and unsuccessful nonoperative management remain unknown. Objectives: To investigate factors associated with the failure of nonoperative management of appendicitis and compare patient-reported outcomes between patients whose treatment succeeded and those whose treatment failed. Design, setting, and participants: This study was a planned subgroup secondary analysis conducted in 10 children's hospitals that included 370 children aged 7 to 17 years with uncomplicated appendicitis enrolled in a prospective, nonrandomized clinical trial between May 1, 2015, and October 31, 2018, with 1-year follow-up comparing nonoperative management with antibiotics vs surgery for uncomplicated appendicitis. Statistical analysis was performed from November 1, 2019, to February 12, 2022. Interventions: Nonoperative management with antibiotics vs surgery. Main outcomes and measures: Failure of nonoperative management and patient-reported outcomes. The relative risk (RR) of failure based on sociodemographic and clinical characteristics was calculated. Patient-reported outcomes were compared based on the success or failure of nonoperative management. Results: Of 370 patients (34.6% of 1068 total patients; 229 boys [61.9%]; median age, 12.3 years [IQR, 10.0-14.6 years]) enrolled in the nonoperative group, treatment failure occurred for 125 patients (33.8%) at 1 year, with 53 patients (14.3%) undergoing appendectomy during initial hospitalization and 72 patients (19.5%) experiencing delayed treatment failure after hospital discharge. Higher patient-reported pain at presentation was associated with increased risk of in-hospital treatment failure (RR, 2.1 [95% CI, 1.0-4.4]) but not delayed treatment failure (RR, 1.3 [95% CI, 0.7-2.3]) or overall treatment failure at 1 year (RR, 1.5 [95% CI, 1.0-2.2]). Pain duration greater than 24 hours was associated with decreased risk of delayed ... |
| نوع الوثيقة: | article in journal/newspaper |
| وصف الملف: | application/pdf |
| اللغة: | English |
| العلاقة: | JAMA Network Open; Minneci PC, Hade EM, Gil LA, et al. Demographic and Clinical Characteristics Associated With the Failure of Nonoperative Management of Uncomplicated Appendicitis in Children: Secondary Analysis of a Nonrandomized Clinical Trial. JAMA Netw Open. 2022;5(5):e229712. Published 2022 May 2. doi:10.1001/jamanetworkopen.2022.9712; https://hdl.handle.net/1805/33965Test |
| الإتاحة: | https://doi.org/10.1001/jamanetworkopen.2022.9712Test https://hdl.handle.net/1805/33965Test |
| حقوق: | Attribution 4.0 International ; http://creativecommons.org/licenses/by/4.0Test/ |
| رقم الانضمام: | edsbas.76E4ABB2 |
| قاعدة البيانات: | BASE |
| الوصف غير متاح. |