Appendicitis in the elderly
1Chinese University of Hong Kong, Department of Surgery, Prince of Wales Hospital, Shatin, Hong Kong.
The Australian and New Zealand Journal of Surgery
|August 17, 2000
Summary
Elderly patients with acute appendicitis face high risks. Expedient surgery and appropriate antibiotic use can minimize complications, but severe pre-existing conditions increase mortality risk.
Area of Science:
- Geriatric Medicine
- Surgical Gastroenterology
- Clinical Outcomes Research
Background:
- Acute appendicitis in individuals over 60 years old is linked to elevated morbidity and mortality rates.
- A retrospective analysis of 10 years of treatment experience and outcomes for acute appendicitis in elderly patients was conducted.
Purpose of the Study:
- To review the experience and outcomes of treating acute appendicitis in patients aged 60 and above.
- To identify factors influencing morbidity and mortality in elderly patients with acute appendicitis.
Main Methods:
- Retrospective review of 130 patient case notes diagnosed with acute appendicitis.
- Analysis of diagnosis timing, surgical approach, and patient comorbidities.
Main Results:
- A significant delay in diagnosis was observed in patients with perforated appendicitis.
- Midline or paramedian incisions correlated with increased wound infection rates and longer hospital stays.
- The overall morbidity rate was 28%, and the mortality rate was 2.3%, with all deaths linked to severe pre-existing comorbid conditions.
Conclusions:
- Acute appendicitis in the elderly remains a condition with significant morbidity.
- Prompt diagnosis, surgical intervention, perioperative antibiotics, and right lower quadrant incisions can mitigate morbidity.
- Severe pre-existing medical conditions are a primary determinant of mortality in this patient group.
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