Management and outcome of appendicitis among octogenarians in an English hospital over a five year period

McGowan, David; Howlader, M.; Patel, Roshani; Swindlehurst, Nicola; Manifold, D.K.; Shaikh, Irshad

doi:10.1016/j.ijsu.2011.10.004

Cited by 6 publications

(5 citation statements)

References 8 publications

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“…The most common symptoms associated with acute appendicitis are also observed in elderly patients—lower abdominal pain (93.9–97.6%), anorexia (57.6–67.0%), nausea and vomiting (45.5–68.3%), shifting pain (30.3–45.1%), right iliac fossa pain (60.6%), and pyrexia (21.2–26.8%) [ 13 , 14 ]. Elderly patients may not have conclusive clinical signs of acute appendicitis, but signs of peritonitis—abdominal distention, reduced abdominal wall movement, severe tenderness, localized and generalized guarding—are more pronounced [ 4 ].…”

Section: Clinical Signsmentioning

confidence: 99%

“…The prevalence of complicated appendicitis increases with age: 13.6–20.97% in patients younger than 40 [ 5 , 11 , 39 ], 37.5% in those aged 40–64 years [ 39 ], 43.97% in those aged 65–74 [ 39 ], and 56.84–63.0% in those aged above 75 [ 5 , 39 ], with an even bigger increase after age of 80 (64.9–72.7%) [ 12 , 13 ].…”

Section: Uncomplicated Versus Complicated Appendicitismentioning

confidence: 99%

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Acute Appendicitis in the Elderly: A Literature Review on an Increasingly Frequent Surgical Problem

et al. 2021

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With increased life expectancy and the growing total population of elderly patients, there has been rise in the number of cases of acute appendicitis in elderly people. Although acute appendicitis is not the most typical pathological condition in the elderly, it is not uncommon. Most of these patients require surgical treatment, and as with any acute surgical pathology in advanced age, treatment possibilities are affected by comorbidities, overall health status, and an increased risk of complications. In this literature review we discuss differences in acute appendicitis in the elderly population, with a focus on clinical signs, diagnostics, pathogenesis, treatment, and results.

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Section: Clinical Signsmentioning

confidence: 99%

Section: Uncomplicated Versus Complicated Appendicitismentioning

confidence: 99%

Acute Appendicitis in the Elderly: A Literature Review on an Increasingly Frequent Surgical Problem

et al. 2021

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“…22 Trauma Surgery Unit, Maggiore Hospital Regional Emergency Surgery and Trauma Center, Bologna Local Health District, Bologna, Italy. 23 Operative Unit of Infectious Diseases, S. Orsola-Malpighi University Hospital, Bologna, Italy. 24 Division of General Surgery, Rambam Health Care Campus, Haifa, Israel.…”

Section: Availability Of Data and Materials Not Applicablementioning

confidence: 99%

“…Furthermore, in almost all the included studies, the average time from symptoms onset to admission and from admission to theatre was greater in older patients than in younger ones [2,6,8,12,23,24].…”

Section: Introductionmentioning

confidence: 99%

The SIFIPAC/WSES/SICG/SIMEU guidelines for diagnosis and treatment of acute appendicitis in the elderly (2019 edition)

et al. 2020

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The epidemiology and the outcomes of acute appendicitis in elderly patients are very different from the younger population. Elderly patients with acute appendicitis showed higher mortality, higher perforation rate, lower diagnostic accuracy, longer delay from symptoms onset and admission, higher postoperative complication rate and higher risk of colonic and appendiceal cancer. The aim of the present work was to investigate age-related factors that could influence a different approach, compared to the 2016 WSES Jerusalem guidelines on general population, in terms of diagnosis and management of elderly patient with acute appendicitis. During the XXIX National Congress of the Italian Society of Surgical Pathophysiology (SIFIPAC) held in Cesena (Italy) in May 2019, in collaboration with the Italian Society of Geriatric Surgery (SICG), the World Society of Emergency Surgery (WSES) and the Italian Society of Emergency Medicine (SIMEU), a panel of experts participated to a Consensus Conference where eight panelists presented a number of statements, which were developed for each of the four topics about diagnosis and management of acute appendicitis in elderly patients, formulated according to the GRADE system. The statements were then voted, eventually modified and finally approved by the participants to the Consensus Conference. The current paper is reporting the definitive guidelines statements on each of the following topics: diagnosis, non-operative management, operative management and antibiotic therapy.

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“…However, complicated appendicitis with perforation, gangrene, or abscess is relatively common, with an incidence that may be similar for all age groups [6,8]. On the other hand increased rate of peri-operative complications in elderly patients is well documented and the most common specific perioperative complications are post-operative wound infection and gastrointestinal disturbances, with general complications including pneumonia and cardiovascular problems [9][10][11][12].…”

Section: Introductionmentioning

confidence: 99%

Outcomes of acute appendicitis in elderly patients: a 5-year experience at a single institution

Gökakın¹,

Atabey²,

Uysal³

et al. 2013

Basic Clin Sci

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Aim. Outcomes after elective surgical procedures are seemed as if similar in younger and older patients; however, urgent surgeries may cause significant morbidity and mortality in older patients. The aim of study was to present our management experience on acute appendicitis in elderly patient group. Methods. Patients who underwent appendectomy for acute appendicitis between 2007-2012 were included in the study. Individuals with other reasons of acute abdomen not defined as acute appendicitis were excluded. With these criteria, 1382 patients were included in the study. Patients were divided into three age groups: group I; younger than 29, group II; 29 to 65, and group III; 65 and older. Variables selected for analysis included age, sex, duration of symptoms, duration of hospitalization (total and preoperative), operative approach, operative findings, operative time, morbidity and mortality rates, and pathological confirmation. Results. Duration of symptoms and hospitalization (total and preoperative) were higher in the group III. Postoperative outcomes were worse in the group III compared to the other groups. However, miss diagnosis rate was lower in that age group. Conclusions. Acute appendicitis in the elderly remains a challenge for practicing surgeons and continues to be associated with high morbidity. With increasing life expectancy, more such cases are likely to be encountered in the future.

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Management and outcome of appendicitis among octogenarians in an English hospital over a five year period

Cited by 6 publications

References 8 publications

Acute Appendicitis in the Elderly: A Literature Review on an Increasingly Frequent Surgical Problem

Acute Appendicitis in the Elderly: A Literature Review on an Increasingly Frequent Surgical Problem

The SIFIPAC/WSES/SICG/SIMEU guidelines for diagnosis and treatment of acute appendicitis in the elderly (2019 edition)

Outcomes of acute appendicitis in elderly patients: a 5-year experience at a single institution

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