Association between allergic rhinitis and Children with appendectomy---
a nationwide population-based cohort study
Abstract
Background The appendix plays and important role to the human
intestinal microbiota and immunity. Thus, appendectomy may alter immune
function and intestinal biofilm. Allergic rhinitis is a common disease
which is due to imbalance of TH2/TH1 cells and cytokine. The aim of this
study was to evaluate the risk of allergic rhinitis after appendectomy
in children. Methods The data source was the National Health
Insurance Research Database (NHIRD), which is a large, population-based
database in Taiwan. We collected 4013 patients who had undergone
appendectomy (case group) between January 1,2000 and December 31st ,
2018 and matched them with 16,052 patients who had not undergone
appendectomy (control group) by sex and age using proportional
propensity score (PSM) at a ratio of 1:4 after excluding patients with a
diagnosis of allergic rhinitis in the year prior to appendectomy. In
addition, Poisson regression and subgroup analyses were used to
investigate the relative risk of development of allergic rhinitis after
appendectomy in children. Results The relative risk of
subsequent allergic rhinitis in patients who had undergone appendectomy
was found to be higher (R.R= 1.24; 95% CI, 1.18-1.30; p<
0.001) than in patients who had never undergone appendectomy. Subgroup
analysis showed the risk of allergic rhinitis after appendectomy were
significantly higher in patients aged 6-11 years (HR=1.20; 95%
CI,1.10-1.32, P<0.001) and 12-18 years (HR=1.25; 95%
CI,1.17-1.33; P< 0.01), and for both genders (HR=1.24;95%
CI,1.15-1.34;p< 0.001 for women; HR=1.23;95%
CI,1.15-1.31;p< 0.001 for men), living place (Urban, HR=1.25;
95%CI,1.17-1.33; p<0.001) ( Suburban areas, HR=1.20;
95%CI,1.10-1.31; p< 0.001), and lower income groups
(Conclusion Appendectomy was correlated with a 1.24-fold increased risk
of developing allergic rhinitis in children, especially within 5-years
of follow-up. Therefore, we suggest that the indication of appendectomy
should be carefully evaluated to decide the best way to treat acute
appendicitis.