Incidence of Acute Nonperforated and Perforated Appendicitis: Age‐specific and Sex‐specific Analysis

Kørner, Hartwig; Søndenaa, Karl; Søreide, Jon Arne; Andersen, E.; Nysted, Arne; Lende, Tone Hoel; Kjellevold, Kjell H.

doi:10.1007/s002689900235

Cited by 397 publications

(293 citation statements)

References 17 publications

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“…The association found between age and risk of PA is in agreement with previous studies 9,27 . The main reason for this increased risk has been suggested to be delayed diagnosis 28 .…”

Section: Discussionsupporting

confidence: 93%

“…Perforation of the appendix occurs in 20-30 per cent of cases of acute appendicitis 4,8 and is associated with an increased risk of various complications. Perforated appendicitis (PA) occurs most frequently in children aged less than 5 years and in patients over 65 years old 9 . However, it has also been shown that the incidence of PA is independent of age 2 .…”

Section: Introductionmentioning

confidence: 99%

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Impact of body mass index and tobacco smoking on outcome after open appendicectomy

Sadr–Azodi

Lindström

Adami

et al. 2008

British Journal of Surgery

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Background: The effect of body mass index (BMI) and smoking on the risk of perforated appendix and postoperative complications in patients undergoing open appendicectomy for acute appendicitis was studied. Results: After adjustment for age, calendar period and BMI, smoking was significantly associated with an increased risk of perforated appendicitis (PA) (P = 0·004). The relative risk was 1·29 (95 per cent confidence interval 1·11 to 1·50) among current smokers with more than 10 pack-years of tobacco use. In patients with non-perforated appendicitis (NPA), the relative risk of overall postoperative complications was significantly associated with BMI (P < 0·001), and was 2·60 (1·71 to 3·95) in obese patients and 1·51 (1·03 to 2·22) in current smokers with more than 10 pack-years of tobacco use. In patients with PA, overweight, obesity and smoking status were not associated with an increased risk of overall postoperative complications.Conclusion: Perforation due to acute appendicitis was associated with current tobacco smoking. A BMI of 27·5 kg/m 2 or more and current smoking were associated with overall postoperative complications in patients with NPA.

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“…The association found between age and risk of PA is in agreement with previous studies 9,27 . The main reason for this increased risk has been suggested to be delayed diagnosis 28 .…”

Section: Discussionsupporting

confidence: 93%

Section: Introductionmentioning

confidence: 99%

Impact of body mass index and tobacco smoking on outcome after open appendicectomy

Sadr–Azodi

Lindström

Adami

et al. 2008

British Journal of Surgery

View full text Add to dashboard Cite

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“…Acute appendicitis can be seen in all age groups whereas it commonly affects younger population in the second and third decades of life (11,12). As the global life expectancy increases and the population gets older, some disease may shift to elderly.…”

Section: Discussionmentioning

confidence: 99%

Retrospective cohort study of elderly patients with acute appendicitis

Arer¹,

Kus²,

Akkapulu³

et al. 2017

J Turgut Ozal Med Cent

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Aim: Appendicitis is the most common surgical cause of abdominal pain among the patients being admitted to Emergency department. Although it affects younger patients, its incidence increases in elderly as the population gets older. Higher perforation and complication rates have been reported in elderly patients. The aim of this study is to investigate appendicitis in patients older than 65 years. Material and Methods: A total of 61 patients with performed appendectomy older than 65 years age were included in this study. Laparoscopic and open appendectomies were included. Data were collected retrospectively. Patients were analyzed according to demograhic data, operative findings, complications and mortality. Results: Of 61 patients, 34 (55.7%) were male and 27 (44.3%) were female. The mean age was found to be 71.59 years. The average duration of symptoms were 3.2 days. Laparoscopic appendectomy was performed in only 4 (6.6%) patients. The mean hospital stay was found to be 3.89 days. Complications were found in 13 (21.3%) patients. Mortality was found to be 3.3%. Perforated appendicitis was found to be associated with physical findings, CRP level and hospital stay (p<0.05). Abdominal ultrasound has a sensitivity of 45.2% and specificity of 66.7% and computerized tomography has higher sensitivity (82.1%) and specificity (100%). Conclusion: Prompt diagnosis and treatment should be performed in the elderly patients with suspected appendicitis in order to prevent complications and mortality. Radiological modalities should be used to ensure accurate diagnosis of appendicitis in elderly patients.

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“…Parte de la explicación a este fenómeno se encuentra en la heterogeneidad de los pacientes que se presentan en el grupo de probabilidad intermedia, por lo general, ancianos, inmunosuprimidos y mujeres en edad fértil (17,18). En especial, en este último grupo se ha reconocido que existe una tasa mayor de apendicectomías no terapéuticas (19)(20)(21)(22)(23), situación que ha motivado el uso rutinario de la ecografía y la tomografía abdominal (24,25) y de otros métodos diagnósticos, así como la recolección estructurada de datos (26). Esto sugiere que las mujeres en edad fértil y con hallazgos clínicos de dolor en la fosa ilíaca derecha, deben someterse a un período de observación más largo o a un escrutinio diagnóstico mucho más intenso, como se observa en el presente estudio.…”

Section: Discussionunclassified

Evaluación de escalas diagnósticas en pacientes con dolor abdominal sugestivo de apendicitis

et al. 2007

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Introducción. El diagnóstico de apendicitis es difícil y existen algunas escalas que pretenden mejorar la exactitud diagnóstica. Objetivo. Determinar las características operativas de las escalas de Alvarado y Fenyö, comparándolas con la impresión diagnóstica del cirujano y la patología en el dolor abdominal sugestivo de apendicitis. Materiales y métodos. Se trata de un estudio prospectivo de evaluación de pruebas diagnósticas. Se registraron los signos, síntomas y resultados de exámenes de laboratorio incluidos en las escalas. Se registró de manera ciega el diagnóstico del cirujano y su conducta. Se determinó la sensibilidad, especificidad, valores diagnósticos positivos y negativos, y likelihood ratio (índice de verosimilitud) de cada escala y del cirujano, discriminado por sexo. Resultados. Se analizaron 374 sujetos, sin diferencias estadísticamente significativas de variables entre sexos. Se operaron 269 pacientes. El 16,9% de los hombres y el 31,4% de las mujeres no tuvieron apendicitis. Para los hombres, la sensibilidad del diagnóstico por el cirujano fue mayor que las escalas (86,2% Vs. 73% en Alvarado Vs. 67,2% en Fenyö) con una especificidad similar. Para las mujeres la sensibilidad del cirujano y la escala de Alvarado fueron similares y superiores a la de Fenyö (77,1% Vs. 79,5% en Alvarado y 47% en Fenyö) pero la especificidad fue superior para Fenyö (92,9% Vs. 71,4% en Alvarado y 75,9% en cirujano). La frecuencia de apendicitis crece de manera proporcional al puntaje de Alvarado. Conclusión. Para hombres con dolor en la fosa iliaca derecha, el diagnóstico hecho por el cirujano es mejor que las escalas diagnósticas. Para el caso de las mujeres, la escala de Fenyö ofrece una mejor sensibilidad. La escala de Alvarado puede facilitar la conducta en pacientes con dolor en fosa iliaca derecha.Palabras clave: apendicitis/diagnóstico, escala creciente, sensibilidad y especificidad, dolor abdominal Evaluation of diagnostic scales for appendicitis in patients with lower abdominal pain Introduction. Diagnosis of apendicitis is difficult; however several clinical scales have been developed that attempt to improve diagnostic accuracy. Objective. The operational characteristics of Alvarado and Fenyö scales were defined in patients with abdominal pain suggestive of appendicitis and were compare with clinical and pathological diagnoses. Material and methods. A prospective trial assessed the diagnostic tests. Sign, symptoms, and laboratory tests were included in scales selected. Surgeon decision was maintained independent from the results of the scales. Sensitivity, specificity, positive and negative predictive value and positive and negative likelihood ratio for each scale was compared with the surgeon evaluation. Results. The sample included 374 patients with approximately equal sexes. Of these 269 patients underwent surgery. Howeve, 16.9% of the male and 31.4% of female patients did not have appendicitis. For men, a diagnosis made by the surgeon had better sensitivity than scales (86.2% vs. 73% for Alvarado and 67....

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Incidence of Acute Nonperforated and Perforated Appendicitis: Age‐specific and Sex‐specific Analysis

Cited by 397 publications

References 17 publications

Impact of body mass index and tobacco smoking on outcome after open appendicectomy

Impact of body mass index and tobacco smoking on outcome after open appendicectomy

Retrospective cohort study of elderly patients with acute appendicitis

Evaluación de escalas diagnósticas en pacientes con dolor abdominal sugestivo de apendicitis

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