Epidemiology and socioeconomic features of appendicitis in Taiwan: a 12-year population-based study

Abstract

IntroductionThis paper presents an epidemiologic study of appendicitis in Taiwan over a twelve-year period. An analysis of the incidence in the low-income population (LIP) is included to explore the effects of lower socioeconomic status on appendicitis.MethodsWe analyzed the epidemiological features of appendicitis in Taiwan using data from the National Health Insurance Research Database (NHIRD) from 2000 to 2011. All cases diagnosed as appendicitis were enrolled.ResultsThe overall incidences of appendicitis, primary appendectomy, and perforated appendicitis were 107.76, 101.58, and 27.20 per 100,000 per year, respectively. The highest incidence of appendicitis was found in persons aged 15 to 29 years; males had higher rates of appendicitis than females at all ages except for 70 years and older. Appendicitis rates were 11.76 % higher in the summer than in the winter months. A multilevel analysis with hierarchical linear modeling (HLM) revealed that male patients, younger patients (aged ≤14 years), and elderly patients (aged ≥60 years) had a higher risk of perforated appendicitis; among adults, the incidence increased with age. Moreover, the risk of perforation was higher in patients with one or more comorbidities. LIP patients comprised 1.25 % of the total number of patients with appendicitis from 2000 to 2011. The overall incidence of appendicitis was 34.99 % higher in the LIP than in the normal population (NP), and the incidence of perforated appendicitis was 40.40 % higher in the LIP than in the NP. After multivariate adjustment, the adjusted hospital costs and length of hospital stay (LOS) for the LIP patients were higher than those for the NP patients.ConclusionsAppendicitis and appendectomy in Taiwan had similar overall incidences, seasonality patterns, and declining trends compared to numerous previous studies. Compared to NP patients, LIP patients had a higher risk of appendicitis, longer LOS and higher hospital costs as a result of appendectomy.

Acute appendicitis: Epidemiology, treatment and outcomes- analysis of 16544 consecutive cases

“…Clinical scores have been developed and proposed in the last years to help surgeons reaching a diagnosis of acute appendicitis, such as the Alvarado and the Andersson score[22,23]: The decrease in the incidence rate could be explained by the diffusion of these scores and a consequent increased attention in the diagnosis of acute appendicitis, in order to reduce the rate of negative appendectomies. As expected, acute appendicitis is more frequent in young and male patients (Figure 1), as reported by the literature[18-20], with augmented incidence among patients in the 7-25 years categories. In the years categories 14-25, acute appendicitis is more frequent in females: A possible reason is the starting of childbearing ages and the sexual transmitted disorders that could mime acute appendicitis - with lower quadrant abdominal pain - and a consequent higher rate of negative appendectomies, as reported by Seetahal et al[3].…”

“…Acute appendicitis in Northern Italy has a crude rate of 89 cases per 100000 inhabitants per year, and this data is comparable to similar studies in other country worldwide[18-21]. Surprisingly, during the study period the incidence decreased significantly, from 120 to 73 cases per 100000 inhabitants.…”

Conservative treatment versus surgery for uncomplicated appendicitis in children: a systematic review and meta-analysis

“…Also, results were not reported according to age categories. Considering the known increased perforation rate for infants under 5 years of age,19 conservative treatment in this subgroup may be even less efficacious and more hazardous than in older children. Moreover many ‘children’ over 14 years of age are structurally similar to adults, implying that strict age comparison (rather than, eg, the onset of secondary sexual characteristics) may be misleading.…”

Risk of Appendicitis among Children with Different Piped Water Supply: A Nationwide Population-Based Study

“…Perforated appendicitis (ICD-9 540.0, 540.1) were also assessed. The case definition of appendicitis has been validated in numerous studies [1,2]. …”

“…Appendicitis is the most common surgical condition for children, with an annual incidence of approximately 0.1% and cumulative incidence of 3.2% by age 20 [1,2]. However, for such a common disease, its etiology is not yet fully understood.…”