[Acute appendicitis in the elderly patient]

Area of Science:

• Geriatric Medicine
• Surgical Pathology
• Emergency Medicine

Background:

• Acute appendicitis is a common surgical emergency.
• Elderly patients present unique diagnostic and management challenges.
• Appendicitis in older adults can lead to higher morbidity and mortality.

Purpose of the Study:

• To evaluate the diagnostic delay and outcomes of acute appendicitis in patients over 65 years old.
• To determine the factors contributing to high morbidity in this age group.
• To assess the rate of perforated appendicitis and its relation to diagnostic timelines.

Main Methods:

• Retrospective analysis of 55 patients aged over 65 undergoing appendectomy for suspected acute appendicitis.
• Histological examination to confirm appendicitis and assess appendix normality.
• Review of clinical history to determine diagnostic delay (time from symptom onset to surgery).

Main Results:

• Out of 55 patients, 49 (89.1%) had confirmed acute appendicitis after histology.
• A significant diagnostic delay was observed: >24 hours in 63.2% and >48 hours in 34.6% of cases.
• A high rate of perforated appendicitis (36.7%) was found, strongly correlated with prolonged symptom duration.

Conclusions:

• Delayed diagnosis and surgical intervention are major contributors to the high morbidity of acute appendicitis in elderly patients.
• Prompt appendectomy is essential to mitigate complications and improve outcomes in geriatric appendicitis cases.
• While perforated appendicitis is common, the study did not show an increased rate of early perforations in this specific elderly cohort compared to general appendicitis populations.