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[Acute appendicitis in the elderly (author's transl)]

J Bladé Creixenti, A Martínez Vea, C Heimann Navarra

    Medicina Clinica
    |April 25, 1980
    PubMed
    Summary

    Elderly patients with acute appendicitis experience delayed diagnosis, more severe symptoms, and higher mortality rates compared to younger individuals. This highlights critical differences in appendicitis presentation and outcomes in older adults.

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    Area of Science:

    • Geriatric Medicine
    • Surgical Pathology

    Background:

    • Acute appendicitis is a common surgical emergency.
    • Age significantly impacts disease presentation and outcomes.

    Purpose of the Study:

    • To compare clinical, analytical, radiographic, and pathological data of acute appendicitis in elderly patients (over 60) versus younger patients (under 60).
    • To analyze differences in diagnostic delay, symptom presentation, complication rates, and mortality between the two age groups.

    Main Methods:

    • Retrospective comparison of 31 elderly patients and 100 younger patients diagnosed with acute appendicitis.
    • Analysis of clinical presentation, laboratory results, radiographic findings, pathological data, and mortality rates.

    Main Results:

    • Elderly patients exhibited a greater delay in seeking medical consultation and presented with more diffuse abdominal pain.
    • A higher incidence of perforated and gangrenous appendicitis was observed in the elderly group.
    • Mortality rate was 13% in the elderly group, compared to 0% in the younger group; no significant differences in analytical or radiographic findings were noted.

    Conclusions:

    • The aged appendix may have unique characteristics contributing to delayed diagnosis and increased severity of acute appendicitis.
    • Delayed consultation and intrinsic appendiceal changes in the elderly contribute to higher rates of perforation, gangrene, and mortality.
    • Acute appendicitis management in elderly patients requires careful consideration of age-related factors to improve outcomes.

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