Association of meteorological factors with pediatric acute appendicitis in China: A 7-year retrospective analysis

Abstract

Acute appendicitis (AA) affects between 7% and 8% of the world population and is one of the most common general surgical emergencies. The concept of seasonal patterns in the incidence of AA remains controversial. Thus, this study aimed to investigate whether meteorological factors are related to variations in the rate of pediatric AA cases at the Children's Hospital in Chongqing, China.In total, in this retrospective survey, 3436 children younger than 18 years who had been hospitalized with AA from January 1, 2008 to December 31, 2013 were enrolled, and the meteorological factors during this period were collected.Patients with AA showed a male/female ratio of 1.81:1; the highest incidence age ranged from 6 to 12 years old (P < .0001). The highest incidences of pediatric AA occurred in summer and autumn, with a peak in September and a trough in February. Pearson correlation analysis showed that the monthly mean temperature (r = 0.357, P = .001), monthly mean relative humidity (r = -0.357, P = .001), and monthly mean sunshine duration (r = 0.235, P = -0.031) were relatively weak correlated with pediatric AA. Multiple linear regression analysis indicated that pediatric AA occurrence was positively affected by monthly mean temperature (P < .0001) and negatively affected by monthly mean humidity (P < .0001) and monthly sum of sunshine (P < .0001), while monthly mean air pressure (P = .092), monthly wind speed (P = .143) and monthly precipitation (P = .297) were marginally associated with pediatric AA.Pediatric AA is associated with climatic factors. Specifically, pediatric AA is more likely related to the following meteorological conditions of: high temperature (20 °C-30 °C), low humidity, and less sunshine.

Figure 1

Age and gender distributions of acute appendicitis from 2008 to 2014. (A) Age distribution and acute appendicitis cases. (B) Gender distribution and acute appendicitis cases.

Figure 2

Incidence time distribution of acute appendicitis from 2008 to 2014. (A) Monthly distribution and acute appendicitis cases. (B) Seasonal distribution and acute appendicitis cases.

Figure 3

Distribution of meteorological data in Chongqing from 2008 to 2014. (A) Temperature per month and acute appendicitis cases. (B) Air pressure per month and acute appendicitis cases. (C) Humidity per month and acute appendicitis cases. (D) Wind speed per month and acute appendicitis cases. (E) Sum of sunshine per month and acute appendicitis cases. (F) Precipitation per month and acute appendicitis cases.

Figure 4

Temperature and number of cases of acute appendicitis from 2008 to 2014.