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Acute appendicitis in the elderly: risk factors for perforation
Abdelkarim H Omari1, Muhammad R Khammash, Ghazi R Qasaimeh
1Department of General Surgery and Urology, King Abdullah University Hospital, Jordan University of Science and Technology, 22110 Irbid, Jordan. akomari@just.edu.jo.
World Journal of Emergency Surgery : WJES
|January 17, 2014
Summary
Pre-hospital delay is the main risk factor for perforated appendicitis in elderly patients. Early diagnosis and treatment, including CT scans, are crucial to reduce mortality and morbidity in this population.
Area of Science:
- Geriatric Surgery
- Emergency Medicine
- Gastrointestinal Surgery
Background:
- Acute appendicitis is a common surgical emergency, with perforation posing a significant risk, especially in elderly individuals.
- Identifying risk factors for perforation in older patients is critical for timely intervention.
Purpose of the Study:
- To identify risk factors associated with appendiceal perforation in patients over 60 years old presenting with acute appendicitis.
Main Methods:
- Retrospective review of 214 elderly patients (age > 60) with confirmed acute appendicitis from 2003-2013.
- Comparison of perforated versus non-perforated groups based on demographics, clinical presentation, and time delays.
- Diagnostic methods included clinical assessment, ultrasonography (US), and computed tomography (CT) scans.
Main Results:
- Appendiceal perforation occurred in 41% of elderly patients (87/214).
- Pre-hospital time delay was identified as the most significant risk factor for perforation.
- Postoperative complications and mortality were significantly higher in the perforated group.
Conclusions:
- Acute appendicitis in the elderly is a serious condition where perforation increases morbidity and mortality.
- Prompt hospital admission and investigation for abdominal pain in elderly patients are essential.
- Early utilization of CT scans can expedite appropriate treatment and improve outcomes.
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