Management, treatment and outcomes of acute appendicitis in an elderly population: a single-center experience

Cohen-Arazi, O; Dabour, K; Bala, Manju; Haran, Áine; Almogy, Gidon

doi:10.1007/s00068-016-0735-9

Cited by 19 publications

(27 citation statements)

References 15 publications

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“…19 General Surgery, Salerno University, Salerno, Italy. 20 Department of Surgery, Macerata Hospital, Macerata, Italy. 21 General, Mininvasive and Bariatric Surgery Unit, Department of Advanced Medical and Surgical Sciences, University of Campania Luigi Vanvitelli, Caserta, Italy.…”

Section: Availability Of Data and Materials Not Applicablementioning

confidence: 99%

“…Furthermore, according to almost all authors, elderly patients were significantly more likely than other age groups to have complicated appendicitis with perforation or abscess. The complicated appendicitis rate ranges from 18 to 70% [2,[4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21] (compared to a rate ranging from 3 to 29% among patients younger than 65 years old). The reason for this high risk of perforation could be the vascular sclerosis that the vermiform appendix develops in elderly patients and the narrowing of the lumen by fibrosis.…”

Section: Introductionmentioning

confidence: 99%

“…Focusing on appendectomy, compared to young patients, elderly patients are burdened by a higher postoperative mortality [21,25], a higher post-operative morbidity [12,21], a longer length of stay [12], a longer operative time [12], a lower laparoscopic appendectomy rate [12,14,20] and a higher risk to receive more complex procedures [14]. In a large Swedish study [25] on more than 117,000 patients, the case fatality rate after appendectomy was strongly influenced by age with a threefold increase for each decade of age, reaching more than 16% in the nonagenarians.…”

Section: Introductionmentioning

confidence: 99%

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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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Section: Availability Of Data and Materials Not Applicablementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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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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“…In der aktuellen Literatur zur akuten Appendizitis wird der Anteil der Altersappendizitis zwischen 5-10 % angegeben. Charakteristisch für die Altersappendizitis sind schwere und unspezifische klinische Verläufe, die mit einer hohen Komplikationsrate verbunden sind [29]. In Anbetracht der komplikationsarmen bzw.…”

Section: Indikationsstellung Zur Baunclassified

Begleitappendektomie: ja oder nein?

et al. 2017

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At more than 50%, appendicitis is the leading cause of acute intra-abdominal disease requiring surgery. In the course of various other operations, prophylactic appendectomy (PA) is frequently performed. This study examines to what extent PA is justified. A prospective study was performed in all patients (n = 173) undergoing prophylactic appendectomy in Katharinen Hospital Unna between January 2010 and October 2013. The following variables were analysed: age, gender, type of primary surgery, emergency or elective surgery, complications, lethality, intraoperative and histopathological evaluation of the appendix. In addition, patients were contacted postoperatively with the request to complete a questionnaire. Prophylactic appendectomy was carried out without any specific complications. 117 patients (68%) participated in the survey. 15% of these patients had suffered symptoms that could be attributable to irritation of the appendix. With only one exception, all appendectomy specimens revealed pathological findings in the histopathological examination. PA allowed the early diagnosis of 4 adenomas, one neuroendocrine tumour and 6 metastases or manifestations of peritoneal carcinomatosis. PA is ethically justifiable, as there are few complications. Moreover, it can help to avoid future appendicitis and allows early detection of malignancies.

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“…Although appendicitis is often thought of as a disease of the young, it has been reported that there has been a higher proportion of the population aged 60 or over with AA in recent years in association with increasing life expectancy [1,[8][9][10][11]. However, it has also been speculated that whether this change was a real event occurring on a national level for the United States [1].…”

Section: Introductionmentioning

confidence: 99%

Is the increased incidence of pathologically proven acute appendicitis more likely seen in elderly patients? A retrospective cohort study

et al. 2021

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Aim: Although appendicitis is a disease of the young, it has been speculated that its incidence has increased among the elderly people. In this study, it was aimed to evaluate annual changes of appendicitis seen in older patients (!60 years) throughout a 10-year period. Methods: All adult patients who were surgically treated for acute appendicitis were retrospectively analyzed with respect to pathological analysis, gender, age and proportion of the patients aged 60 or over in an annual base. Variability in the mean age and proportion of the older patients aged 60 or over throughout the study years were regarded as the main outcomes. Results: There were 3296 patients with a mean age of 30.42 ± 12 years. Distribution of gender was similar (p ¼ 0.636). There was a significant positive correlation in the mean age of the patients throughout the study years (p ¼ 0.043). Stratification by the age of 60 yielded a significant increase in percent of the older patients, from 0.93% at 2007 to 4.28% at 2016 (p ¼ 0.019). Conclusions: The mean age of the patients with acute appendicitis is going to increase. Therefore, it is expected that all surgeons are more likely to be confronted with elderly patients with appendicitis in the near-future.

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Management, treatment and outcomes of acute appendicitis in an elderly population: a single-center experience

Cited by 19 publications

References 15 publications

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

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

Begleitappendektomie: ja oder nein?

Is the increased incidence of pathologically proven acute appendicitis more likely seen in elderly patients? A retrospective cohort study

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