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PubMed · 10945554

Appendicitis in the elderly.

J F Lee·C K Leow·W Y Lau
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Abstract

BACKGROUND: Acute appendicitis in the elderly (i.e. those over 60 years of age) is associated with high morbidity and mortality rates. The present retrospective study reviews 10 years ( 1986-1996) of experience and outcome in treating acute appendicitis in patients aged 60 or above. METHODS: One hundred and thirty patients with acute appendicitis were identified and their case notes reviewed. RESULTS: Acute appendicitis was diagnosed at admission in 84 patients (64.6%). The remaining patients were observed for a median duration of 9.4 h prior to diagnosis and treatment. Patients with an underlying perforated acute appendix had a significantly longer period of pain prior to admission (P = 0.029; Mann-Whitney U-test) but perforation per se was not associated with a significantly higher rate of morbidity and longer length of hospital stay. In contrast, the use of midline or paramedian incisions was associated with a higher wound infection rate (P=0.003; Pearson chi-squared test) and a longer hospital stay (P<0.001; Mann Whitney U-test). None of the patients were subsequently found to have an underlying colonic neoplasm. The overall morbidity rate was 28%. The mortality rate was 2.3% and all three patients who died had a severe comorbid medical condition prior to developing acute appendicitis. CONCLUSIONS: Acute appendicitis in the elderly is still associated with significant morbidity. But once acute appendicitis is diagnosed, then expedient surgery, appropriate use of perioperative antibiotics and a right lower quadrant incision can help to minimize the morbidity. Pre-existing severe comorbid medical condition(s) is a major contributory factor to mortality in these patients.

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Abdominal PainAcute DiseaseAgedAged, 80 and overAnti-Bacterial AgentsAppendectomyAppendicitisCombined Modality TherapyComorbidityFemaleHumansIntestinal PerforationLength of StayMaleMiddle AgedMorbidityRetrospective StudiesRupture, SpontaneousSurgical Wound InfectionTime FactorsTreatment OutcomeJournal Article

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J F Lee, C K Leow, W Y Lau. 2000. Appendicitis in the elderly.. https://doi.org/10.1046/j.1440-1622.2000.01905.x

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