AB077. SOH22ABS122. A review of appendicitis-related acute referrals to Children’s Health Ireland from non-specialist paediatric surgical centres
General Session II

AB077. SOH22ABS122. A review of appendicitis-related acute referrals to Children’s Health Ireland from non-specialist paediatric surgical centres

Zakya Penny, Kate Rigney, Sami Elwahab, Brendan O’Connor, Sinead Hassett, Farhan Tareen, Brice Antao, Sri Paran, Brian Sweeney

Department of Paediatric Surgery, Children’s Health Ireland at Crumlin (CHI), Dublin, Ireland

Background: Acute appendicitis is the commonest surgical emergency in children. Eighty percent of the 3,197 paediatric appendicectomies are performed in Ireland annually are performed by adult general surgeons; the remaining 20% are performed at Children’s Health Ireland (CHI) centres. Occasionally patients are referred from Non-Specialist Paediatric Surgical Centres (NSPSC) to CHI for specialized preoperative or postoperative care. To review referrals to CHI with acute appendicitis or its complications from NSPSC, identify indications for transfer determine the outcomes for this cohort of patients.

Methods: Retrospective review of transfers to CHI in Crumlin, Temple Street and the National Children’s Hospital Tallaght for management of acute appendicitis-related disease from January 2020 to November 2021. Studied variables included: demographics, hospital levels, quoted indications of transfer, LOS in CHI, management post-transfer, and outcomes.

Results: A total of 74 patients were transferred to CHI from (NSPSC) during the study period with appendicitis or its complications (males 60.9%), 9±4.3 years, mean age (0–16 years). Nineteen percent of patients were under the age of 5 years. Approximately ninety-six percent (71 of 74) of referring hospitals were level 4 care centres. Ninety-seven percent were transferred with suspected acute appendicitis, and the rest were referred post-appendicectomy with postoperative complications. The overall morbidity rate for those referred pre-operatively was 13.8%. The mean LOS in CHI was 6.9±10.7 days (1–79 days).

Conclusions: Adult general surgical surgeons provide the bulk of care of paediatric appendicitis in Ireland. In a small minority of cases adult surgical centres refer patients with appendicitis for specialized pre or postoperative care to CHI. This critical adult surgical service needs to be preserved to prevent overwhelming the national specialist paediatric surgical services.

Keywords: Appendicectomy; appendicitis referral; paediatric appendicectomy; paediatric appendicitis; paediatric laparoscopy

Acknowledgments

Funding: None.

Footnote

Conflicts of Interest: The authors have no conflicts of interest to declare.

Ethical Statement: The authors are accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0/.

doi: 10.21037/map-22-ab077
Cite this abstract as: Penny Z, Rigney K, Elwahab S, O’Connor B, Hassett S, Tareen F, Antao B, Paran S, Sweeney B. AB077. SOH22ABS122. A review of appendicitis-related acute referrals to Children’s Health Ireland from non-specialist paediatric surgical centres. Mesentery Peritoneum 2022;6:AB077.

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