Pediatric Cholecystectomy Case Volume and Complexity Following the COVID-19 Pandemic.

IF 6.2 2区医学 Q1 PEDIATRICS

Pediatrics Pub Date : 2025-02-21 DOI:10.1542/peds.2024-068065

Olivia A Keane, Shadassa Ourshalimian, Romeo Ignacio, Shannon Acker, Aaron Jensen, Katrine Lofberg, Claudia Mueller, Benjamin E Padilla, Samir Pandya, David H Rothstein, Katie W Russell, Caitlin Smith, MaKayla O'Guinn, Madeleine Ing, Gretchen Floan Sachs, Alexandra Highet, Stephanie E Iantorno, Lauren R Templeton, Brielle Ochoa, Utsav M Patwardhan, Alyssa Peace, Marisa E Schwab, Tina H Tran, Lorraine I Kelley-Quon

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引用次数: 0

Abstract

Background and objectives: Historically, cholecystectomy was infrequently performed in children. Lifestyle changes, delays in health care access, and increases in childhood obesity occurred during the COVID-19 pandemic. The impact of these shifts on need for cholecystectomy are poorly understood. We evaluate trends in cholecystectomy case volume among children during the COVID-19 pandemic.

Methods: A multi-institutional retrospective cohort study was conducted for children ages 18 years and younger who underwent cholecystectomy from January 1, 2016, to July 31, 2022, at 10 children's hospitals. Differences in cholecystectomy case mix and volume before and during the pandemic were identified using bivariate comparisons and interrupted time series analysis.

Results: Overall, 4282 children were identified: 2122 before the pandemic and 2160 during the pandemic. Most were female (74.2%) with a median age of 15 years (IQR, 13.0-16.0 years). The proportion of Hispanic (55.0% vs 60.1%; P = .01) patients, body mass index (BMI) (26.0 vs 27.1; P < .001), and obesity (BMI > 30) (30.8% vs 37.4%; P < .001) increased during the pandemic. Predicted monthly case volume increased from 40 to 100 during the pandemic. Patients transferred from an outside hospital increased (21.3% vs 28.5%; P < .001). Significant increases in acute cholecystitis (12.2% vs 17.3%; P < .001), choledocholithiasis (12.8% vs 16.5%; P = .001), gallstone pancreatitis (10.6% vs 12.4%; P = .064), and chronic cholecystitis (1.4% vs 3.2%; P < .001) also occurred. On interrupted time series analysis, change in month-to-month case count significantly increased during the pandemic (Figure 1; P < .001), which persisted after exclusion of transferred patients.

Conclusions: Pediatric cholecystectomy case volume and complexity increased during the COVID-19 pandemic. These findings may be secondary to changes in childhood health, transfer patterns, and shifts in access, highlighting an increased health care burden on children's hospitals.

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背景和目的：历史上，儿童很少接受胆囊切除术。在 COVID-19 大流行期间，生活方式发生了改变，医疗保健服务延迟，儿童肥胖症增加。人们对这些变化对胆囊切除术需求的影响知之甚少。我们评估了 COVID-19 流行期间儿童胆囊切除术病例量的变化趋势：我们对 2016 年 1 月 1 日至 2022 年 7 月 31 日期间在 10 家儿童医院接受胆囊切除术的 18 岁及以下儿童进行了一项多机构回顾性队列研究。通过双变量比较和间断时间序列分析，确定了大流行之前和期间胆囊切除术病例组合和数量的差异：结果：共发现 4282 名儿童：大流行前为 2122 例，大流行期间为 2160 例。大部分为女性（74.2%），年龄中位数为 15 岁（IQR，13.0-16.0 岁）。西班牙裔患者的比例（55.0% vs 60.1%；P = .01）、体重指数（BMI）（26.0 vs 27.1；P 30）（30.8% vs 37.4%；P 结论：小儿胆囊切除术病例中，女性患者的比例较高：在 COVID-19 大流行期间，小儿胆囊切除术的病例量和复杂性都有所增加。这些发现可能与儿童健康状况的变化、转院模式和就医途径的转变有关，凸显了儿童医院医疗负担的加重。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Pediatrics 医学-小儿科

CiteScore

12.80

自引率

5.00%

发文量

791

审稿时长

2-3 weeks

期刊介绍： The Pediatrics® journal is the official flagship journal of the American Academy of Pediatrics (AAP). It is widely cited in the field of pediatric medicine and is recognized as the leading journal in the field. The journal publishes original research and evidence-based articles, which provide authoritative information to help readers stay up-to-date with the latest developments in pediatric medicine. The content is peer-reviewed and undergoes rigorous evaluation to ensure its quality and reliability. Pediatrics also serves as a valuable resource for conducting new research studies and supporting education and training activities in the field of pediatrics. It aims to enhance the quality of pediatric outpatient and inpatient care by disseminating valuable knowledge and insights. As of 2023, Pediatrics has an impressive Journal Impact Factor (IF) Score of 8.0. The IF is a measure of a journal's influence and importance in the scientific community, with higher scores indicating a greater impact. This score reflects the significance and reach of the research published in Pediatrics, further establishing its prominence in the field of pediatric medicine.