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The Worldwide Epidemiology of Acute Appendicitis: An Analysis of the Global Health Data Exchange Dataset
Dakshitha P Wickramasinghe1, Chrisjit Xavier2, Dharmabandhu N Samarasekera2
1Department of Surgery, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka. dakshithaw@srg.cmb.ac.lk.
Background:
This study aims to describe the worldwide epidemiology and changing disease trends of acute appendicitis (AA).
Methods:
Epidemiological data on the incidence of AA and deaths were collected from the Global Health Data Exchange repository from 1990 to 2019. Data were stratified by age, sex and Socio-Demographic Index (SDI).
Results:
In 2019, there were an estimated 17.7 million cases (incidence 228/100,000) with over 33,400 deaths (0.43/100,000). Both the absolute number and the incidence had increased from 1990 to 2019 (+ 38.8% and + 11.4%, respectively). The number of deaths and deaths per 100,000 declined during this period (- 21.8% and - 46.2%, respectively). These trends were largely similar in all 5 SDI groups. There was a significant difference in the incidence of AA between the SDI groups, with low SDI group having the lowest and high SDI group having the highest. The high SDI group had the lowest mortality rate (Kruskall-Wallis test, p < 0.001). The peak incidence was in the 15-19-year age group. The mortality rate increased exponentially from the third decade of life.
Conclusions:
The mortality rate of AA is declining worldwide, while the incidence is increasing. The peak incidence is in the 15-19-year group.
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