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Appendicitis in the elderly.

J F Lee1, C K Leow, W Y Lau

  • 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
PubMed
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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:

Related Experiment Videos

  • 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.