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Acute appendicitis. A 5-year review

M A Ricci1, M F Trevisani, W C Beck

  • 1Guthrie Medical Center, Sayre, Pennsylvania.

The American Surgeon
|May 1, 1991
PubMed

Insights

Perforated appendicitis rates increased significantly, especially in children and older adults. Early diagnosis and public awareness are crucial to reduce complications and prolonged hospital stays.

Area of Science:

  • Medical Research
  • Surgical Outcomes
  • Public Health

Background:

  • Appendicitis is a common surgical emergency.
  • Perforation represents a severe complication of appendicitis.
  • Historical data indicated varying rates of appendicitis perforation.

Purpose of the Study:

  • To review appendicitis perforation rates over a 5-year period.
  • To identify patient groups at higher risk for perforation.
  • To assess the impact of perforation on diagnostic accuracy and patient outcomes.

Main Methods:

  • Retrospective review of appendicitis cases at Guthrie Medical Center.
  • Analysis of perforation rates in 1984 compared to historical data (1964, 1944).
  • Evaluation of diagnostic accuracy and complication rates in perforated versus non-perforated appendicitis.

Main Results:

  • A 31% perforation rate was observed in 1984, a significant increase from previous decades.
  • Perforation occurred in 18.3% of 240 appendicitis cases.
  • Highest perforation risks were in children (34.3%) and adults over 50 (48%).
  • Diagnostic accuracy was 81.4% for 295 operated cases.
  • Perforation was linked to poorer diagnostic accuracy, particularly in women during their reproductive years.
  • Complication rates were higher (29.5%) with perforation versus without (8.7%).
  • Perforation extended hospital stay by an average of 2.5 days.

Conclusions:

  • There has been a concerning rise in appendicitis perforation rates.
  • Young children and the elderly are particularly vulnerable to appendicitis perforation.
  • Improved diagnostic accuracy and public/physician awareness are vital to mitigate perforation risks and improve patient outcomes.

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