The Association Between Barium Examination and Subsequent Appendicitis: A Nationwide Population-Based Study - 18/04/17
Abstract |
Objective |
The incidence and association between appendicitis and barium examination (BE) remain unclear. Such potential risk may be omitted. We conducted a longitudinal, nationwide, population-based cohort study to investigate the association between BE and appendicitis risk.
Methods |
From the Taiwan National Health Insurance Research Database, a total of 24,885 patients who underwent BE between January 1, 2000 and December 31, 2010 were enrolled in a BE cohort; an additional 98,384 subjects without BE exposure were selected as a non-BE cohort, matched by age, sex, and index date. The cumulative incidences of subsequent appendicitis in the BE and non-BE cohorts were assessed using the Kaplan-Meier curves and log-rank test. Cox proportional hazards regression analyses were employed to calculate the appendicitis risk between the groups.
Results |
The cumulative incidence of appendicitis was higher in the BE cohort than in the non-BE cohort (P = .001). The overall incidence rates of appendicitis for the BE and non-BE cohorts were 1.19 and 0.80 per 1000 person-years, respectively. After adjustment for sex, age, and comorbidities, the risk of appendicitis was higher in the BE cohort (adjusted hazard ratio = 1.46, 95% confidence interval = 1.23-1.73) compared with the non-BE cohort, especially in the first 2 months (adjusted hazard ratio = 9.72, 95% confidence interval = 4.65-20.3).
Conclusions |
BE was associated with an increased, time-dependent appendicitis risk. Clinicians should be aware of this potential risk to avoid delayed diagnoses.
Le texte complet de cet article est disponible en PDF.Keywords : Appendicitis, Barium, Epidemiology, Pathogenesis
Plan
| Funding: This study was supported by the grants from the Taiwan Ministry of Health and Welfare Clinical Trial and Research Center of Excellence, (MOHW105-TDU-B-212-133019); China Medical University Hospital and the Academia Sinica Taiwan Biobank Stroke Biosignature Project (BM10501010037); the NRPB Stroke Clinical Trial Consortium (MOST 104-2325-B-039-005); the Tseng-Lien Lin Foundation, Taichung, Taiwan; the Taiwan Brain Disease Foundation, Taipei, Taiwan; Katsuzo and Kiyo Aoshima Memorial Funds, Japan; and China Medical University under the Aim for Top University Plan of the Ministry of Education, Taiwan. The funders had no role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript. No additional external funding was received for this study. |
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| Conflict of Interest: The authors declare no competing interests. |
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| Authorship: The authors' individual contributions are outlined as follows. Conception and design: H-ML and C-HK. Administrative support: C-HK. Data collection and organization: All authors. Data analysis and interpretation: All authors. Manuscript writing: All authors. Final approval of the manuscript: All authors. |
Vol 130 - N° 1
P. 54 - janvier 2017 Retour au numéro
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