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[Appendicitis in the aged].

J Buchholz1, M Mayer, H W Krawzak

  • 1Chirurgische Universitätsklinik, Ruhr-Universität Bochum, Marien-hospital Herne I, Bundesrepublik Deutschland.

Zentralblatt Fur Chirurgie
|January 1, 1991
PubMed
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Older adults with acute appendicitis experience delays in diagnosis and treatment, leading to higher perforation rates and complications. Early diagnosis is crucial for reducing mortality in this vulnerable population.

Area of Science:

  • Geriatric Medicine
  • Surgical Gastroenterology
  • Emergency Medicine

Context:

  • Acute appendicitis presents unique challenges in patients over 60.
  • Delayed presentation is common in elderly individuals with appendicitis.
  • Appendicitis diagnosis in older adults requires careful consideration.

Purpose:

  • To evaluate the clinical presentation, complications, and outcomes of acute appendicitis in patients over 60 years old.
  • To compare appendicitis management in elderly versus younger populations.
  • To identify factors contributing to delayed diagnosis and treatment in geriatric appendicitis cases.

Summary:

  • A retrospective study of 78 patients over 60 with acute appendicitis (1984-1989) revealed a 3x longer delay from symptom onset to treatment compared to younger patients.

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  • This delay resulted in a 53.8% perforation rate and a 4x higher complication rate in the elderly group.
  • Mortality was 4%, with no clear correlation between lab/physical findings and perforation severity.

    • Impact:

    • Highlights the critical need to include appendicitis in the differential diagnosis for acute abdominal pain in older adults.
    • Emphasizes that earlier surgical intervention can significantly reduce postoperative complications and mortality.
    • Informs clinical practice to improve outcomes for geriatric appendicitis patients.