{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,26]],"date-time":"2026-07-26T03:32:43Z","timestamp":1785036763954,"version":"3.55.0"},"reference-count":15,"publisher":"Georg Thieme Verlag KG","issue":"01","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Eur J Pediatr Surg"],"published-print":{"date-parts":[[2024,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n          Objective\u2003Nonoperative management (NOM) for simple acute appendicitis (SAA) is an acceptable mode of treatment in healthy children. Previous studies of NOM routinely excluded young children (&lt; 5 years); however, the effect of age on NOM failure has not been directly assessed. Efficiency of NOM in young adults is questionable. Therefore, adolescents may also be at greater risk of NOM failure. Our aim was to investigate the effect of age on NOM failure.<\/jats:p><jats:p>\n          Methods\u2003This is a retrospective analysis of children with SAA who received NOM between January 1, 2019, and June 30, 2021, at our institution. NOM failure was defined by subsequent appendectomy. Age was assessed as a continuous variable, and we also compared different age subgroups.<\/jats:p><jats:p>\n          Results\u2003In this study, 151 children were included (60% male), mean age 11.2\u2009\u00b1\u20093.2 years (range: 5\u201317). Overall, 66 children (44%) failed NOM, 90% of them within the first year (median 7 weeks). Ten percent of the cohort were younger than 6 years of age and 33% of them failed NOM (p\u2009=\u20090.39). Per 1 year increase in age, the odds of NOM failure increased by 12% (p\u2009=\u20090.027). Children over 14 years of age had 2.46 times higher odds to fail NOM (p\u2009=\u20090.03). These higher odds remained after adjusting for appendiceal diameter and appendicolith. Linear regression showed a decrease by a factor of 12 at the time of NOM failure with every 1-year increase in age (\u03b2\u2009=\u2009\u221212, p\u2009=\u20090.09).<\/jats:p><jats:p>\n          Conclusion\u2003The risk of NOM failure in children increases with age; therefore, age should be considered when deciding on the optimal management of SAA, especially in adolescents. Effectiveness of NOM in children younger than 6 years is noninferior to older children and therefore should not be excluded.<\/jats:p>","DOI":"10.1055\/a-2155-7642","type":"journal-article","created":{"date-parts":[[2023,8,17]],"date-time":"2023-08-17T22:48:59Z","timestamp":1692312539000},"page":"102-106","source":"Crossref","is-referenced-by-count":4,"title":["Age as an Exclusion Criterion for Nonoperative Management in Simple Acute Appendicitis in Children"],"prefix":"10.1055","volume":"34","author":[{"given":"Gal","family":"Becker","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery, Dana Dwek Children's Hospital, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Audelia Eshel","family":"Fuhrer","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery, Dana Dwek Children's Hospital, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keren","family":"Kremer","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery, Dana Dwek Children's Hospital, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annabella","family":"Hochschild","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery, Dana Dwek Children's Hospital, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haguy","family":"Kammar","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery, Dana Dwek Children's Hospital, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Igor","family":"Sukhotnik","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery, Dana Dwek Children's Hospital, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2023,9,29]]},"reference":[{"issue":"05","key":"ref1","doi-asserted-by":"crossref","first-page":"371","DOI":"10.1016\/j.ijsu.2008.06.003","article-title":"Appendicitis in pre-school children: a continuing clinical challenge. A retrospective study","volume":"6","author":"M S Mallick","year":"2008","journal-title":"Int J Surg"},{"issue":"05","key":"ref2","doi-asserted-by":"crossref","first-page":"e2021054693","DOI":"10.1542\/peds.2021-054693","article-title":"Nonoperative management of uncomplicated appendicitis","volume":"149","author":"S C Lipsett","year":"2022","journal-title":"Pediatrics"},{"key":"ref3","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1016\/j.cct.2019.06.013","article-title":"Multi-institutional trial of non-operative management and surgery for uncomplicated appendicitis in children: design and rationale","volume":"83","author":"P C Minneci","year":"2019","journal-title":"Contemp Clin Trials"},{"issue":"11","key":"ref4","doi-asserted-by":"crossref","first-page":"1127","DOI":"10.1111\/jpc.13741","article-title":"Five lessons in uncomplicated appendicitis: can we remove the surgery?","volume":"53","author":"A Read","year":"2017","journal-title":"J Paediatr Child 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children: five-year follow up of a randomized controlled pilot trial","volume":"271","author":"B Patkova","year":"2020","journal-title":"Ann Surg"},{"issue":"01","key":"ref12","first-page":"1685","article-title":"Estimation of age of transition from paediatric to adult healthcare for young people with long term conditions using linked routinely collected healthcare data","volume":"6","author":"S Jarvis","year":"2021","journal-title":"Int J Popul Data Sci"},{"issue":"03","key":"ref13","first-page":"178","article-title":"[Antibiotic treatment vs. appendectomy for non-perforated appendicitis in adults]","volume":"90","author":"S Sch\u00f6lch","year":"2019","journal-title":"Chirurg"},{"issue":"05","key":"ref14","doi-asserted-by":"crossref","first-page":"1022","DOI":"10.1007\/s00268-022-06446-8","article-title":"Efficacy and safety of non-operative management of uncomplicated acute appendicitis compared to appendectomy: an umbrella review of systematic reviews and 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