The Association Between Barium Examination and Subsequent Appendicitis: A Nationwide Population-Based Study

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• 作者：Hao-Ming Li ; MD^a ; Lee-Ren Yeh ; MD^a ; Ying-Kai Huang ; MD^b ; Cheng-Li Lin ; MSc^c ; ^d ; Chia-Hung Kao ; MD^e ; ^f ; ^g ; ^{d10040@mail.cmuh.org.tw}
• 关键词：Appendicitis ; Barium ; Epidemiology ; Pathogenesis
• 刊名：The American Journal of Medicine
• 出版年：2017
• 出版时间：January 2017
• 年：2017
• 卷：130
• 期：1
• 页码：54-60.e5
• 全文大小：511 K
• 卷排序：130

文摘

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.MethodsFrom 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.ResultsThe 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).ConclusionsBE was associated with an increased, time-dependent appendicitis risk. Clinicians should be aware of this potential risk to avoid delayed diagnoses.