The global, regional, and national burden of appendicitis in 204 countries and territories, 1990–2019: a systematic analysis from the Global Burden of Disease Study 2019

Abstract

Background Appendicitis is the most common abdominal surgical emergency worldwide, and its burden has been changing. We report the level and trends of appendicitis prevalence, and incidence; and years lived with disability (YLD) in 204 countries and territories from 1990 to 2019, based on data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019. Methods The numbers and age-standardized prevalence, incidence, and YLD rates per 100,000 population of appendicitis were estimated across regions and countries by age, sex, and sociodemographic index (SDI). All the estimates were reported with 95% uncertainty intervals (UIs). Results Globally, the age-standardized prevalence and incidence rates of appendicitis in 2019 were 8.7 (95% UI 6.9 to 11.0) and 229.9 (95% UI 180.9 to 291.0) per 100,000 population, with increases of 20.8% (95% UI 18.9 to 23.0%) and 20.5% (95% UI 18.7 to 22.8%) from 1990 to 2019, respectively. Additionally, the age-standardized YLDs rate was 2.7 (95% UI 1.8 to 3.9) in 2019, with an increase of 20.4% (95% UI 16.2 to 25.1%) from 1990 to 2019. In 2019, the age-standardized prevalence, incidence, and YLD rates peaked in the 15-to-19-year age groups in both male and female individuals. However, no statistically significant differences were observed between the male and female individuals in all groups. Ethiopia, India, and Nigeria showed the largest increases in the age-standardized prevalence rate between 1990 and 2019. Generally, positive associations were found between the age-standardized YLD rates and SDI at the regional and national levels. Conclusions Appendicitis remains a major public health challenge globally. Increasing awareness of appendicitis and its risk factors and the importance of early diagnosis and treatment is warranted to reduce its the burden.

Local administration of vancomycin powder in orthopaedic fracture surgery: current practice and trends

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Germinal center BCR maturation in appendicitis reveals a role for antigen-specific adaptive immune responses during disease

“…Two donors had a majority of their IgG+ clones map to a memory B cell cluster (C0) (Figure 3C). Interestingly, these two donors had limited clonal expansion compared to the other three donors, highlighting (1) the heterogeneity in immune responses to appendicitis and (2) the possibility that these patients underwent appendectomy early enough in their disease course that they had not mounted a substantial humoral response.…”

“…Appendicitis is one of the most common abdominal emergencies, with an estimated prevalence of 8.7% globally 1 . Historically, appendicitis was thought to be caused by obstruction of the appendiceal orifice via fecalith or tumor, although current evidence suggests this is the exception rather than the rule, and cannot explain the majority of cases 2 .…”

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