{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T22:40:16Z","timestamp":1777934416864,"version":"3.51.4"},"reference-count":24,"publisher":"SAGE Publications","issue":"8","license":[{"start":{"date-parts":[[2017,10,24]],"date-time":"2017-10-24T00:00:00Z","timestamp":1508803200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Surgical Infections"],"published-print":{"date-parts":[[2017,11,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Standardization of antibiotic management of appendicitis in tertiary care pediatric centers has been associated with improved outcomes. Rady Children's Hospital-San Diego implemented an appendicitis clinical pathway in 2005. We evaluated infection-related re-admission risk factors since 2010, when an electronic medical record was established, with the aim to optimize the clinical pathway.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Between January 2010 and August 2015, 4725 children with a diagnosis of appendicitis were evaluated for demographic data, pathology diagnoses, culture results, and inpatient and oral step-down antibiotic therapy regimens. From children originally admitted for appendicitis, those who were re-admitted with infection were compared with those who were not re-admitted for infection. The populations were controlled by severity of infection using a pathology-defined appendicitis severity scale: Grade 0, no appendicitis; grade 1, simple acute appendicitis with gross and microscopic evidence of inflammation, but no perforation; grade 2, gangrenous\/necrotizing\/micro-perforated appendicitis with subserosal or serosal exudate, but no frank or visually appreciated perforation; and grade 3, frank perforation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Of 4725 children (total population, TP) admitted with a diagnosis of appendicitis, only 199 (4.2%) were re-admitted, with 125 of these admissions for infection (2.65% of the TP). Age, race\/ethnicity, language preference, and body mass index were not found to correlate with re-admission for infection. Length of stay significantly differed between the no infection-related re-admission population and infection-related re-admission population (3.02 vs. 4.03 d, p\u2009&lt;\u20090.001). There was a trend toward higher infection\u2013re-admission rates as the pathology grade increased (odds ratio grade 1 vs. grade 3\u2009=\u20092.28, 95% confidence interval 1.03, 5.03).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Infection-related re-admission rates for children on the clinical pathway in our institution were infrequent. The greater association of all-cause and infection-related re-admission rates with pathology grade suggest that defining appendicitis by pathology and clinical severity may provide an evidence-based scoring system to support clinical observation in the use and duration of antibiotic therapy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1089\/sur.2017.104","type":"journal-article","created":{"date-parts":[[2017,10,24]],"date-time":"2017-10-24T11:48:11Z","timestamp":1508845691000},"page":"894-903","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":21,"title":["Low Infection-Related Re-Admission Rates in a Retrospective of 4725 Children with Appendicitis Using a Clinical Pathway in a Tertiary Care Pediatric Center"],"prefix":"10.1177","volume":"18","author":[{"given":"Nikolas E.","family":"Marino","sequence":"first","affiliation":[{"name":"University of California"},{"name":"Rady Children's Hospital San Diego"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kate","family":"Davenport","sequence":"additional","affiliation":[{"name":"University of California"},{"name":"Rady Children's Hospital San Diego"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mary","family":"Hilfiker","sequence":"additional","affiliation":[{"name":"University of California"},{"name":"Rady Children's Hospital San Diego"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Simone","family":"Langness","sequence":"additional","affiliation":[{"name":"University of California"},{"name":"Rady Children's Hospital San Diego"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Timothy","family":"Fairbanks","sequence":"additional","affiliation":[{"name":"University of California"},{"name":"Rady Children's Hospital San Diego"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Erin","family":"Stucky Fisher","sequence":"additional","affiliation":[{"name":"University of California"},{"name":"Rady Children's Hospital San Diego"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert","family":"Newbury","sequence":"additional","affiliation":[{"name":"Rady Children's Hospital San Diego"},{"name":"University of California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Allyson","family":"Andrews","sequence":"additional","affiliation":[{"name":"Rady Children's Hospital San Diego"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alan","family":"Wells","sequence":"additional","affiliation":[{"name":"University of California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Juan D.","family":"Chaparro","sequence":"additional","affiliation":[{"name":"University of California"},{"name":"Rady Children's Hospital San Diego"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John S.","family":"Bradley","sequence":"additional","affiliation":[{"name":"University of California"},{"name":"Rady Children's Hospital San Diego"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2017,10,24]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1093\/oxfordjournals.aje.a115734"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1089\/sur.2004.5.160"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1177\/000313481408000829"},{"key":"e_1_3_3_5_2","first-page":"20","article-title":"Laparoscopic extracorporeal appendectomy in overweight and obese children","author":"Mohan A","year":"2016","unstructured":"Mohan A, , Guerron AD, , Karam PA, et al. Laparoscopic extracorporeal appendectomy in overweight and obese children. 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Extended- versus narrower-spectrum antibiotics for appendicitis. Pediatrics, 2016; 138.","journal-title":"Pediatrics"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpedsurg.2016.10.037"},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.1089\/sur.2016.261"},{"key":"e_1_3_3_19_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpedsurg.2011.04.012"},{"key":"e_1_3_3_20_2","first-page":"57","article-title":"Once-daily ceftriaxone plus metronidazole versus ertapenem and\/or cefoxitin for pediatric appendicitis","volume":"6","author":"Hurst AL","year":"2017","unstructured":"Hurst AL, , Olson D, , Somme S, et al. Once-daily ceftriaxone plus metronidazole versus ertapenem and\/or cefoxitin for pediatric appendicitis. J Pediatric Infect Dis Soc, 2017; 6:57\u201364.","journal-title":"J Pediatric Infect Dis Soc"},{"key":"e_1_3_3_21_2","doi-asserted-by":"publisher","DOI":"10.1055\/s-2007-981369"},{"key":"e_1_3_3_22_2","doi-asserted-by":"publisher","DOI":"10.1097\/SLE.0b013e318244ea16"},{"key":"e_1_3_3_23_2","doi-asserted-by":"publisher","DOI":"10.1177\/1457496913497433"},{"key":"e_1_3_3_24_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1445-2197.2005.03397.x"},{"key":"e_1_3_3_25_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1411162"}],"container-title":["Surgical Infections"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1089\/sur.2017.104","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1089\/sur.2017.104","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1089\/sur.2017.104","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T02:22:38Z","timestamp":1777688558000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1089\/sur.2017.104"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,10,24]]},"references-count":24,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2017,11,1]]}},"alternative-id":["10.1089\/sur.2017.104"],"URL":"https:\/\/doi.org\/10.1089\/sur.2017.104","relation":{},"ISSN":["1096-2964","1557-8674"],"issn-type":[{"value":"1096-2964","type":"print"},{"value":"1557-8674","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,10,24]]}}}