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2010 Annual Meeting Abstracts

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Disparities in perforation rates from acute appendicitis
*Robert A Brenes, *Hussain M.A. Abbas, *Sumanth Suresh, Juan A Sanchez
Saint Mary's Hospital, Waterbury, CT

Objective: To determine if there are disparities in appendicitis rupture rates based on hospital characteristics, patient demographics and socioeconomic status.
Design: Retrospective analysis of all patients with appendicitis from the Nationwide Inpatient Sample (NIS) of the Healthcare Cost and Utilization Project (HCUP) for the years 2003-2007. Chi-square analysis was performed to validate statistical significance.
Setting: HCUP discharge data collected from acute care hospitals, approximating a 20-percent stratified sample of U.S. community hospitals
Patients: 1,502,449 patients with ICD-9 codes for appendicitis were analyzed.
Interventions: None
Main Outcome Measures: Perforation rate.
Results: 275,229 patients (18%) had a perforation. Male gender, age greater than 65, and patients from lower income ZIP codes were more likely to have a perforated appendix (p<0.001). Hospitals of larger size, teaching status, those located in non-metropolitan areas, and in the western part of the US had higher rates of perforation (p<0.001).
Conclusions: In the U.S., there appears to be significant patient-level and hospital-level disparities in perforation rates for acute appendicitis. Further study is needed to assess whether these differences are due to variations in the quality of or access to medical care.

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