Risk Factors of Brender et al for Perforation in a Child with Appendicitis

 

Patient selection: pediatric patient with abdominal pain

 

Risk factors for perforation:

(1) young age (<= 8 years, with appendicitis often not considered)

(2) delay in treatment > 36 hours

(3) no family history of appendicitis (a family history indicates greater awareness)

 

Additional factors:

(1) presence of fecalith

(2) told by the first health care professional contacted to observe the child at home

(3) low social class (in multivariate analysis less significant when other factors present)

 

One factor not mentioned that can lead to a delay in diagnosis is presentation during an outbreak of viral gastroenteritis, when there are many children with abdominal pain.

 

A key message is that any child with abdominal pain should be examined at the physician's office, clinic or hospital.