Appendicectomy is a common procedure in children with a low risk of mortality, however, complication rates and risk factors are largely unknown. This study aimed to characterise the incidence and epidemiology of postoperative complications in children undergoing appendicectomy in the UK. This multicentre prospective observational cohort study, which included children aged 1–16 y who underwent surgery for suspected appendicitis, was conducted between November 2019 and January 2022. The primary outcome was 30-day postoperative morbidity. Data collected included: patient characteristics; comorbidities; and physiological status. Multivariable regression analysis was used to identify independent risk factors for poor outcomes. Data from 2799 children recruited from 80 hospitals were analysed, of which 185 (7%) developed postoperative complications. Children from black and ‘other’ minority ethnic groups were at significantly higher risk of poor outcomes: OR (95%CI) 4.13 (1.87–9.08), p < 0.001 and 2.08 (1.12–3.87), p = 0.021, respectively. This finding was independent of socio-economic status and type of appendicitis found on histology. Other risk factors for complications included: ASA physical status ≥ 3 (OR (95%CI) 4.05 (1.70–9.67), p = 0.002); raised C-reactive protein (OR 95%CI 1.01 (1.00–1.01), p < 0.001); pyrexia (OR (95%CI) 1.77(1.20–2.63), p = 0.004); and peri-operative oxygen supplementation (OR (95%CI) 4.20 (1.44–12.24), p = 0.009). In the UK NHS, which is a universally accessible healthcare system, ethnicity, but not socio-economic status, was associated with an increased risk of postoperative complications in children having surgery for acute appendicitis. Further evaluations and interventions are required to address this health inequality in keeping with NHS and international priorities.

中文翻译：

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小儿阑尾炎急诊手术后并发症的危险因素：一项全国前瞻性观察队列研究

阑尾切除术是儿童的常见手术，死亡风险较低，但并发症发生率和危险因素在很大程度上尚不清楚。本研究旨在了解英国接受阑尾切除术的儿童术后并发症的发生率和流行病学特征。这项多中心前瞻性观察队列研究包括 1-16 岁因疑似阑尾炎接受手术的儿童，于 2019 年 11 月至 2022 年 1 月期间进行。主要结局是术后 30 天的发病率。收集的数据包括：患者特征；合并症；和生理状态。使用多变量回归分析来确定不良结果的独立危险因素。分析了来自 80 家医院的 2799 名儿童的数据，其中 185 名（7%）出现术后并发症。来自黑人和“其他”少数族裔群体的儿童出现不良结局的风险显着较高：OR (95%CI) 分别为 4.13 (1.87–9.08), p < 0.001 和 2.08 (1.12–3.87), p = 0.021。这一发现与社会经济状况和组织学发现的阑尾炎类型无关。并发症的其他危险因素包括： ASA 身体状况 ≥ 3（OR (95%CI) 4.05 (1.70–9.67)，p = 0.002）； C 反应蛋白升高（OR 95%CI 1.01 (1.00–1.01)，p < 0.001）；发热（OR (95%CI) 1.77(1.20–2.63)，p = 0.004）；和围手术期吸氧（OR (95%CI) 4.20 (1.44–12.24)，p = 0.009）。在英国国民医疗服务体系（NHS）这个全民医疗保健系统中，种族而非社会经济地位与接受急性阑尾炎手术的儿童术后并发症的风险增加有关。需要进一步评估和干预来解决这种健康不平等问题，以符合 NHS 和国际优先事项。