ArticlePloS one2015
Health outcomes in US children with abdominal pain at major emergency departments associated with race and socioeconomic status.
Article in PloS one, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
24 citing papers in PubMed, 2 syntheses or guidelines pooled it, 63 citations in OpenAlex.
- Assessing the Impact of Neighborhood and Built Environment on Pediatric Perioperative Care: A Systematic Review of the Literature.Journal of pediatric surgery · 2024Pooled it
- Disparities in Surgical Access: A Systematic Literature Review, Conceptual Model, and Evidence Map.Journal of the American College of Surgeons · 2019Pooled it
- Health Care Utilization and Pediatric Appendicitis: Insights From an Integrated Health System.The Permanente journal · 2026Article
- Adverse childhood experiences and gastrointestinal symptoms in US youth: Psychosocial pathways and protective contexts.Journal of pediatric gastroenterology and nutrition · 2026Article
- A Research Agenda to Mitigate Racial and Ethnic Disparities in U.S. Critical Care Medicine: An Official American Thoracic Society Research Statement.American journal of respiratory and critical care medicine · 2025Article
- Referral to pediatric gastroenterology for chronic abdominal pain differs by patients' individual, family, and community characteristics.Journal of pediatric gastroenterology and nutrition · 2025Article
- Review
- Determinants of surgical approach to pediatric appendicitis in Brazil.Pediatric surgery international · 2025Article
- Sociodemographic predictors of imaging utilization in children with right lower quadrant pain.Pediatric radiology · 2025Article
- Racial Bias in Pediatric Pain Perception.The journal of pain · 2024Article
- Acute pediatric appendicitis in black and white: clinical disparities, impact and future recommendations.Frontiers in pediatrics · 2024Review
- Project Inclusive Genetics: Protecting reproductive autonomy from bias via prenatal patient-centered counseling.HGG advances · 2023Article
- Reasons for Delayed Diagnosis of Pediatric Acute Appendicitis during the COVID-19 Era: A Narrative Review.Diagnostics (Basel, Switzerland) · 2023Review
- Identification of Bias in Ordering Further Imaging in Ethnic Groups With Indeterminate Ultrasound for Appendicitis.Cureus · 2022Article
- Association of Socioeconomic Characteristics With Where Children Receive Emergency Care.Pediatric emergency care · 2022Article
- Racial and Ethnic Differences in Emergency Department Diagnostic Imaging at US Children's Hospitals, 2016-2019.JAMA network open · 2021Article
- Article
- Epidemiology of Pediatric Surgery in the United States.Paediatric anaesthesia · 2020Article
- The influence of patient race on the use of diagnostic imaging in United States emergency departments: data from the National Hospital Ambulatory Medical Care survey.BMC health services research · 2020Article
- Prognostic Factors Associated with Clinical and Economic Outcomes of Appendectomies in Children: A Multilevel Analysis in a National Retrospective Cohort Study.World journal of surgery · 2020Article
Corrections and comments
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Authors and funding
5 authors at 2 institutions in 1 country.
Funding
Abstract
objectiveOver 9.6 million ED visits occur annually for abdominal pain in the US, but little is known about the medical outcomes of these patients based on demographics. We aimed to identify disparities in outcomes among children presenting to the ED with abdominal pain linked to race and SES.
methodsData from 4.2 million pediatric encounters of abdominal pain were analyzed from 43 tertiary US children's hospitals, including 2.0 million encounters in the emergency department during 2004-2011. Abdominal pain was categorized as functional or organic abdominal pain. Appendicitis (with and without perforation) was used as a surrogate for abdominal pain requiring emergent care. Multivariate analysis estimated likelihood of hospitalizations, radiologic imaging, ICU admissions, appendicitis, appendicitis with perforation, and time to surgery and hospital discharge.
resultsBlack and low income children had increased odds of perforated appendicitis (aOR, 1.42, 95% CI, 1.32- 1.53; aOR, 1.20, 95% CI 1.14 - 1.25). Blacks had increased odds of an ICU admission (aOR, 1.92, 95% CI 1.53 - 2.42) and longer lengths of stay (aHR, 0.91, 95% CI 0.86 - 0.96) than Whites. Minorities and low income also had lower rates of imaging for their appendicitis, including CT scans. The combined effect of race and income on perforated appendicitis, hospitalization, and time to surgery was greater than either separately.
conclusionsBased on race and SES, disparity of health outcomes exists in the acute ED setting among children presenting with abdominal pain, with differences in appendicitis with perforation, length of stay, and time until surgery.
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Registered trials
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