Acute appendicitis in the elderly: a 5-year retrospective study

Area of Science:

• Geriatric Medicine
• Surgical Outcomes
• Public Health

Background:

• Acute appendicitis research in the UK has historically excluded or underrepresented elderly patients.
• Previous studies were conducted before the widespread use of broad-spectrum antibiotics, potentially skewing results.
• Geriatric appendicitis presents unique diagnostic and management challenges.

Purpose of the Study:

• To compare the diagnostic accuracy, hospital stay duration, complication rates, and mortality between elderly and younger patients diagnosed with acute appendicitis.
• To assess if advancements in medical care have improved outcomes for elderly appendicitis patients compared to historical data.

Main Methods:

• Retrospective analysis of 30 elderly patients (mean age 72) and 30 younger patients (mean age 23) with confirmed appendicitis from 1980-1985.
• Comparison of pre-operative diagnostic accuracy, length of hospital stay, morbidity, and mortality between the two age groups.

Main Results:

• Elderly patients experienced significantly lower accurate pre-operative diagnoses compared to the younger cohort.
• A longer duration of hospital stay was observed in the elderly group.
• Elderly patients exhibited increased rates of complications and mortality.

Conclusions:

• Acute appendicitis in the elderly is associated with poorer diagnostic accuracy and worse outcomes than in younger patients.
• Despite advances in medicine, the diagnostic accuracy, mortality, and morbidity for elderly appendicitis patients have not improved compared to earlier international studies.
• This study underscores the persistent challenges in managing appendicitis in the geriatric population.