Epidemiological Features of Infantile Hypertrophic Pyloric Stenosis in Taiwanese Children: A Nation-Wide Analysis of Cases during 1997–2007

OBJECTIVE: To describe the epidemiological characteristics of infantile hypertrophic pyloric stenosis (IHPS) in ethnic Chinese children. MATERIALS AND METHODS: We reviewed the National Health Insurance claims database and analyzed data from children less than one year of age who had been diagnosed with IHPS (ICD-9-CM 750.5) and had undergone pyloromyotomy (ICD-9-CM 43.3). We analyzed the incidence, gender, age at diagnosis, length of hospital stay, seasonal variation and cost of IHPS from data collected between January 1997 and December 2007. RESULTS: A total of 1,077 infants met inclusion criteria, including 889 boys and 188 girls. The annual incidence of IHPS ranged from 0.30 to 0.47 per 1,000 live births with a mean incidence of 0.39 per 1,000 live births. Between 2002 and 2007, the incidence showed a declining trend (P = 0.025) with coincidentally increasing trends for both exclusive breastfeeding (P = 0.014) and breastfeeding plus bottle feeding (P = 0.004). The male-to-female rate ratio was dynamic and increased from 3.03 during the first two weeks of life to 8.94 during the 8(th) through 10th weeks of life. The overall male-to-female rate ratio was 4.30. The mean age at diagnosis was 43.1 ± 2.4 days. After analyzing the months of birth and hospital admission, no seasonal variation associated with IHPS was detected. The mean length of hospital stay was 8.28 ± 7.10 days. CONCLUSIONS: The incidence of IHPS in Taiwan, a country with a majority ethnic Chinese population, was lower than observed incidences in Caucasian populations living in Western countries. Breastfeeding campaigns and low maternal smoking rates may contribute to the lower incidence of IHPS in Taiwan. However, additional studies with longer follow-up periods are needed

Epidemiology of Childhood Intussusception and Determinants of Recurrence and Operation: Analysis of National Health Insurance Data Between 1998 and 2007 in Taiwan

To study the epidemiology of childhood intussusception and risk factors of recurrence and operation based on a nationwide data. Methods: Children with hospitalization due to intussusception (ICD9: 560.0) between 1998 and 2007 were identified from a national health insurance database. The incidence was calculated by age, sex, calendar year and month of admission. Recurrence and operation rates, duration and costs of hospitalization were analyzed. Results: A total of 8217 intussusception-related hospitalizations were identified in 7541 children. The incidence of intussusception peaked between 3 and 36 months of age. Male -to-female incidence rate ratio increased from 1.31 in the first year to 2.52 in the ninth year of life. The overall recurrence and operation rates were 7.9% and 24.9%, respectively. In children less than 1 year old, the recurrence rate was 10.1%, which decreased to 5.3% in children over 3 years old. Multiple logistic regression analysis showed that children receiving operation had a significantly lower risk of recurrence with an odds ratio (95% confidence interval) of 0.31 (0.24-0.41) after controlling for age and sex. There are significantly more cases occurring during the warmer months between May and October compared to the cooler months between November and April. Conclusions: There was a male predominance of intussusception with a dynamic male-to-female incidence rate ratio. Children under 1 year of age have the highest recurrence and operation rates. Seasonal variation of intussusception was suspected in Taiwan

Case numbers of pyloromyotomy in the two genders and the male-to-female rate ratio in Taiwanese children between 1997 and 2007.

<p>*The live birth numbers of male and female infants were approximate 1.1: 1 in each age group. So, the male/female ratio was the case number rates further divided by 1.1.</p

Case number and accumulated percent of cases by weeks of life at diagnosis between 1997 and 2007 in Taiwan.

<p>Case number and accumulated percent of cases by weeks of life at diagnosis between 1997 and 2007 in Taiwan.</p

Annual incidence rate (per 1,000 live births) of pyloromyotomy among 1077 cases occurring between 1997 and 2007 in Taiwan.

<p>Annual incidence rate (per 1,000 live births) of pyloromyotomy among 1077 cases occurring between 1997 and 2007 in Taiwan.</p

Comparison of the incidence and male-to-female rate of pyloric stenosis at different times and in different parts of the world.

<p>F indicates female, M indicates male, NA indicates not available, UK indicates United Kingdom, USA indicates United States America, Hispanic-US indicates US-born Hispanic, Hispanic-F indicates foreign-born Hispanic.</p