TY - JOUR
T1 - Asthma and Risk of Appendicitis in Children
T2 - A Population-Based Case-Control Study
AU - Hasassri, M. Earth
AU - Jackson, Eric R.
AU - Ghawi, Husam
AU - Ryoo, Eell
AU - Wi, Chung Il
AU - Bartlett, Mark G.
AU - Volcheck, Gerald W.
AU - Moir, Christopher R.
AU - Ryu, Euijung
AU - Juhn, Young J.
N1 - Publisher Copyright:
© 2016 Academic Pediatric Association
PY - 2017/3/1
Y1 - 2017/3/1
N2 - Objective To assess whether asthma is associated with risk of appendicitis in children. Methods We used a population-based case-control study design using a comprehensive medical record review and predetermined criteria for appendicitis and asthma. All children (age younger than 18 years of age) who resided in Olmsted County, Minnesota, and developed appendicitis between 2006 and 2012 were matched to controls (1:1) with regard to birthday, gender, registration date, and index date. Asthma status was ascertained using predetermined criteria. Active (current) asthma was defined as the presence of asthma symptoms or asthma-related events (eg, medication use, clinic visits, emergency department, or hospitalization) within 1 year before the index date. Inactive asthma was defined as subjects without these events. A conditional logistic regression model was used. Results Among the 309 appendicitis cases identified, when stratified according to asthma status, active asthma was associated with significantly increased risk of appendicitis compared with inactive asthma (odds ratio [OR] = 2.48; 95% confidence interval [CI], 1.22–5.03) and to no asthma (OR = 1.88; 95% CI, 1.07–3.27; overall P = .035). When controlling for potential confounders such as gender, age, and smoking status, active asthma was associated with a higher odds of developing appendicitis compared with nonasthmatic patients (adjusted OR = 1.75; 95% CI, 0.99–3.11) whereas inactive asthma was not (overall P = .049). Tobacco smoke exposure within 3 months was associated with an increased risk of appendicitis (adjusted OR = 1.66; 95% CI, 1.02–2.69). Among asthma medications, leukotriene receptor antagonists reduced the risk of appendicitis (OR = 0.18; 95% CI, 0.04–0.74). Conclusions Active asthma might be an unrecognized risk factor for appendicitis in children whereas a history of inactive asthma does not pose such risk. Further investigation exploring the underlying mechanisms is warranted.
AB - Objective To assess whether asthma is associated with risk of appendicitis in children. Methods We used a population-based case-control study design using a comprehensive medical record review and predetermined criteria for appendicitis and asthma. All children (age younger than 18 years of age) who resided in Olmsted County, Minnesota, and developed appendicitis between 2006 and 2012 were matched to controls (1:1) with regard to birthday, gender, registration date, and index date. Asthma status was ascertained using predetermined criteria. Active (current) asthma was defined as the presence of asthma symptoms or asthma-related events (eg, medication use, clinic visits, emergency department, or hospitalization) within 1 year before the index date. Inactive asthma was defined as subjects without these events. A conditional logistic regression model was used. Results Among the 309 appendicitis cases identified, when stratified according to asthma status, active asthma was associated with significantly increased risk of appendicitis compared with inactive asthma (odds ratio [OR] = 2.48; 95% confidence interval [CI], 1.22–5.03) and to no asthma (OR = 1.88; 95% CI, 1.07–3.27; overall P = .035). When controlling for potential confounders such as gender, age, and smoking status, active asthma was associated with a higher odds of developing appendicitis compared with nonasthmatic patients (adjusted OR = 1.75; 95% CI, 0.99–3.11) whereas inactive asthma was not (overall P = .049). Tobacco smoke exposure within 3 months was associated with an increased risk of appendicitis (adjusted OR = 1.66; 95% CI, 1.02–2.69). Among asthma medications, leukotriene receptor antagonists reduced the risk of appendicitis (OR = 0.18; 95% CI, 0.04–0.74). Conclusions Active asthma might be an unrecognized risk factor for appendicitis in children whereas a history of inactive asthma does not pose such risk. Further investigation exploring the underlying mechanisms is warranted.
KW - appendicitis
KW - asthma
KW - atopy
KW - control
KW - epidemiology
KW - gastrointestinal inflammation
KW - risk
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U2 - 10.1016/j.acap.2016.09.006
DO - 10.1016/j.acap.2016.09.006
M3 - Article
C2 - 27964827
AN - SCOPUS:85007564512
SN - 1876-2859
VL - 17
SP - 205
EP - 211
JO - Academic Pediatrics
JF - Academic Pediatrics
IS - 2
ER -