Asthma and Risk of Appendicitis in Children

A Population-Based Case-Control Study

M. Earth Hasassri, Eric R. Jackson, Husam Ghawi, Eell Ryoo, Chung Il Wi, Mark G. Bartlett, Gerald W. Volcheck, Christopher R. Moir, Euijung Ryu, Young J Juhn

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

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.

Original languageEnglish (US)
JournalAcademic Pediatrics
DOIs
StateAccepted/In press - Mar 9 2016

Fingerprint

Appendicitis
Case-Control Studies
Asthma
Population
Odds Ratio
Confidence Intervals
Logistic Models
Leukotriene Antagonists
Ambulatory Care
Smoke
Tobacco
Medical Records
Hospital Emergency Service

Keywords

  • Appendicitis
  • Asthma
  • Atopy
  • Control
  • Epidemiology
  • Gastrointestinal inflammation
  • Risk

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this

Asthma and Risk of Appendicitis in Children : A Population-Based Case-Control Study. / Hasassri, M. Earth; Jackson, Eric R.; Ghawi, Husam; Ryoo, Eell; Wi, Chung Il; Bartlett, Mark G.; Volcheck, Gerald W.; Moir, Christopher R.; Ryu, Euijung; Juhn, Young J.

In: Academic Pediatrics, 09.03.2016.

Research output: Contribution to journalArticle

Hasassri, M. Earth ; Jackson, Eric R. ; Ghawi, Husam ; Ryoo, Eell ; Wi, Chung Il ; Bartlett, Mark G. ; Volcheck, Gerald W. ; Moir, Christopher R. ; Ryu, Euijung ; Juhn, Young J. / Asthma and Risk of Appendicitis in Children : A Population-Based Case-Control Study. In: Academic Pediatrics. 2016.
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abstract = "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.",
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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

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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.

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