Decline in admission rates for acute appendicitis in England

Kang, Jin Yong; Hoare, Jonathan; Majeed, Azeem; Williamson, R. C. N.; Maxwell, J. D.

doi:10.1002/bjs.4363

Cited by 59 publications

(56 citation statements)

References 17 publications

(24 reference statements)

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“…The incidence rate was reported to decrease markedly between 1950 and 1965, with a less steep decrease between 1965 and 1980. Several studies1 3, 4 22, 23 have reported further reduced incidence rates of acute appendicitis in North America and Europe. In addition, in studies with a paediatric focus, the incidence rate of acute appendicitis has previously been reported to decline.…”

Section: Discussionmentioning

confidence: 99%

“…The life‐time risk of acute appendicitis is estimated to be 7–8 per cent1. Studies from Europe and North America report decreasing rates of acute appendicitis, both in general1, 2, 3, 4 and in children5 6. There have been, however, more recent reports of stabilized7 8 or even increased9, 10, 11 incidence rates during the first decade of the 21st century.…”

Section: Introductionmentioning

confidence: 99%

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Population-based cohort study on the epidemiology of acute appendicitis in children in Sweden in 1987-2013

et al. 2018

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BackgroundThe long‐term incidence of acute appendicitis has been reported to be declining in Europe and North America. Recent reports, however, indicate stabilized or even increased rates. The aim of this study was to investigate the present epidemiology of acute appendicitis and appendicectomy in a population‐based cohort of Swedish children.MethodsThe Swedish National Patient Register was queried for all children with acute appendicitis and/or appendicectomy in 1987–2013. Population‐based incidence rates were calculated. Rates were age‐ and sex‐adjusted, and analysed for temporal and regional trends.ResultsSome 56 774 children with acute appendicitis were identified, of whom 53 478 (94·2 per cent) underwent appendicectomy. The incidence rate of acute appendicitis declined by 43·7 per cent over 26 years, from 177·7 to 100·1 per 100 000 person‐years between 1987 and 2013. The most significant reduction was for non‐perforated appendicitis, from 138·5 to 68·4 per 100 000 person‐years between 1987 and 2009. The incidence rate of perforated appendicitis decreased from 28·0 to 19·9 per 100 000 person‐years and negative appendicectomies reduced from 48·5 to 3·6 per 100 000 person‐years during the study interval.ConclusionThe incidence rates of acute appendicitis and negative appendicectomy have reduced markedly in Swedish children over time, with significantly different trends amongst non‐perforated appendicitis and perforated appendicitis. The full explanation for the observed findings is unclear.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Population-based cohort study on the epidemiology of acute appendicitis in children in Sweden in 1987-2013

et al. 2018

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“…Although the incidence of appendicitis is thought to be falling, 3 almost 200 adult appendicectomies were performed over the 12-month period at our institution which serves a population of 350,000. It can be seen that it is a condition that can affect all ages but is most common in patients aged less than 30 years.…”

Section: Discussionmentioning

confidence: 99%

Acute Appendicitis – A Benign Disease?

Simpson

Samaraweera

Sara

et al. 2008

annals

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The treatment of choice is appendicectomy and trials have suggested that, although the laparoscopic approach may have some advantages, there is no clear benefit of this over the open approach. As a consequence, the method of appendicectomy is often dictated by operator experience and facilities available. The majority of recent studies on the management of patients having an appendicectomy are from within the confines of a clinical trial and, due to selection criteria, do not reflect the whole patient case load undergoing the procedure. Most patients recover quickly from appendicectomy but a minority can suffer postoperative complications. This review of case notes was undertaken to assess the frequency of these complications in unselected patients. Patients and MethodsAdult patients (> 16 years of age) undergoing an emergency appendicectomy in the 12-month period between 1 February 2004 and 31 January 2005 were identified from a key word search of 'appendix' from pathology and theatre record databases. Details of presenting symptoms, time to operation, operative procedure, histology and postoperative complications were obtained from the patients' case notes. A complicated recovery was assumed to have occurred if a patient did not recover in the conventional manner. This was defined by the presence of a complication which prolonged the postoperative stay for >4days, admission to a critical care area and/or the need for re-operation or re-admission. Complications were divided into septic (i.e. infective) or non-septic depending on the nature and aetiology. Appendicitis is the most common cause of the acute abdomen and can affect all age groups. Most patients recover quickly but a minority can suffer postoperative complications. This case-note review was undertaken to assess the frequency of these complications.

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“…To compound this further, it appears that the incidence of admission with appendicitis has fallen significantly over the last decade. 4 As well as informing us who performs appendicectomy, and when, the data collected by NCEPOD also reveal which surgical approach is used. Most patients with appendicitis were managed by a standard 'gridiron' or curvilinear 'Lanz'-type approach, but a significant number had their appendix removed through a laparotomy incision.…”

Section: Discussionmentioning

confidence: 99%