Journal of pediatric surgery · 2013
Cholecystectomy in English children: evidence of an epidemic (1997-2012).
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Khoo Abigail Kate, Cartwright Rufus, Berry Simon, Davenport Mark
Аннотация
BACKGROUND/PURPOSE: The purpose of this study was to calculate the incidence of cholecystectomy among children aged ≤ 16 in England between 1997 and 2012 and to assess trends in risk factors.
METHODS: A nationwide retrospective cohort study using the Hospital Episode Statistics Database for episodes of cholecystectomy in children aged ≤ 16 was performed. Age and sex-specific annual incidence rates were derived using Office of National Statistics mid-year population estimates. Trends in the observed case mix were tested using univariable linear regression.
RESULTS: 2808 paediatric cholecystectomies were identified. The incidence of cholecystectomy increased from 0.78/100,000 to 2.7/100,000 (P<0.0001). Sex-specific incidences increased from 1.1 to 4.36/100,000 (P<0.0001) among girls and from 0.48 to 1.13/100,000 (P<0.0001) among boys. There were significant changes in case mix, with an increasing proportion of female cases (69% to 79%, P=0.02), an increase in cases of white ethnicity (48% to 77%, P<0.0001), but only a modest increase in those with a diagnosis of sickle cell anaemia (4% to 6%, P=0.02), and no significant increase in other haemolytic anaemias.
CONCLUSIONS: There has been a three-fold increase in the incidence of paediatric cholecystectomy in England since 1997, with a particular rise among white females. Although data on BMI were not available, the observed effect may be a consequence of increasing levels of teenage obesity.
METHODS: A nationwide retrospective cohort study using the Hospital Episode Statistics Database for episodes of cholecystectomy in children aged ≤ 16 was performed. Age and sex-specific annual incidence rates were derived using Office of National Statistics mid-year population estimates. Trends in the observed case mix were tested using univariable linear regression.
RESULTS: 2808 paediatric cholecystectomies were identified. The incidence of cholecystectomy increased from 0.78/100,000 to 2.7/100,000 (P<0.0001). Sex-specific incidences increased from 1.1 to 4.36/100,000 (P<0.0001) among girls and from 0.48 to 1.13/100,000 (P<0.0001) among boys. There were significant changes in case mix, with an increasing proportion of female cases (69% to 79%, P=0.02), an increase in cases of white ethnicity (48% to 77%, P<0.0001), but only a modest increase in those with a diagnosis of sickle cell anaemia (4% to 6%, P=0.02), and no significant increase in other haemolytic anaemias.
CONCLUSIONS: There has been a three-fold increase in the incidence of paediatric cholecystectomy in England since 1997, with a particular rise among white females. Although data on BMI were not available, the observed effect may be a consequence of increasing levels of teenage obesity.