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. 2003 Aug;46(4):263-8.

Epidemiologic features of acute appendicitis in Ontario, Canada

Mohammed Al-Omran  1 , Muhammad Mamdani, Robin S McLeod
Affiliations

Epidemiologic features of acute appendicitis in Ontario, Canada

Mohammed Al-Omran et al. Can J Surg. 2003 Aug.

Abstract
in English, French

Introduction: To describe the epidemiology of acute appendicitis in the Province of Ontario, we carried out a retrospective population-based cohort study of all patients with acute appendicitis.

Methods: Using hospital discharge abstracts of patients with acute appendicitis from all acute care hospitals in Ontario for the fiscal years 1991-1998 coded for the Canadian Institute for Health Information, we studied the demographic features, particularly age and sex, length of hospital stay (LOS), incidence, and seasonal variation of acute appendicitis.

Results: During the observation period, 65,675 cases of acute appendicitis occurred in Ontario. Of these, 58% of the patients were male and 35.5% had perforation. The mean (and standard deviation [SD]) LOS for patients with perforation was 6.2 (5.3) days versus 3 (1.8) days for patients with no perforation (p < 0.001). The age-specific incidence of acute appendicitis followed a similar pattern for males and females, but males had higher rates in all age groups. The incidence was highest in those aged 10-19 years. The annual age and sex-adjusted incidence of acute appendicitis was 75 per 100,000 population. The female:male age-adjusted rate ratio was 1:1.4. During the study period, the rate of acute appendicitis decreased by 5.1%, but the rate of appendicitis with perforation increased by 13%. A significant seasonal effect was also observed, with the rate of acute appendicitis being higher in the summer months.

Conclusions: Appendicitis is more common in males, in those aged 10-19 years, and during the summer months. The frequency of acute appendicitis appears to be decreasing whereas the proportion of cases with perforation appears to be increasing. This may reflect a change in the population structure in Ontario and restrictions placed on the patient access to the health care system.

Introduction: Pour décrire l'épidémiologie de l'appendicite aiguë en Ontario, nous avons réalisé une étude rétrospective stratifiée représentative par cohorte qui a porté sur tous les patients atteints d'appendicite aiguë.

Méthodes: Dans tous les hôpitaux de soins actifs de l'Ontario, pour les exercices 1991 à 1998 codés selon l'Institut canadien d'information sur la santé, nous avons utilisé les résumés de congé d'hôpital des patients qui ont eu une appendicite aiguë et nous avons étudié les caractéristiques démographiques, particulièrement l'âge et le sexe, la durée du séjour à l'hôpital (DSH), l'incidence et la variation saisonnière de l'appendicite aiguë.

Résultats: Au cours de la période d'observation, il y a eu 65 675 cas d'appendicite aiguë en Ontario. De ce total, 58 % des patients étaient des hommes et 35,5 % avaient subi une perforation. La DSH moyenne (et l'écart type [ET]) chez les patients victimes d'une perforation s'est établie à 6,2 (5,3) jours par rapport à 3 (1,8) jours dans le cas des patients qui n'avaient pas eu de perforation (p < 0,001). L'incidence selon l'âge de l'appendicite aiguë a suivi une tendance semblable chez les hommes et les femmes, mais les hommes présentaient des taux plus élevés dans tous les groupes d'âge. L'incidence était la plus élevée chez les 10 à 19 ans. L'incidence annuelle comparative de l'appendicite aiguë selon l'âge ou le sexe s'établissait à 75 pour 100 000 habitants. Le ratio femme:homme comparatif selon l'âge s'établissait à 1:1,4. Pendant la période visée par l'étude, le taux d'appendicite aiguë a diminué de 5,1 %, mais celui des cas d'appendicite avec perforation a augmenté de 13 %. On a aussi observé un effet saisonnier important : le taux d'appendicite aiguë était plus élevé l'été.

Conclusions: L'appendicite est plus répandue chez les hommes, chez les 10 à 19 ans et pendant les mois d'été. La fréquence de l'appendicite aiguë semble à la baisse tandis que la proportion des cas de perforation semble augmenter. Ces statistiques peuvent refléter un changement de la structure démographique de l'Ontario et des restrictions imposées sur l'accès au système de santé pour les patients.

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Figures

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FIG. 1. Trends in acute appendicitis in Ontario per 100 000 population for the fiscal years 1991–1998 by year and sex. Diamonds = age- and sex-adjusted rate, squares = age- adjusted rate in females, triangles = age-adjusted rate in males (applies also to Figs. 2 and 3).
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FIG. 2. Trends in acute appendicitis without perforation in Ontario per 100 000 population for the fiscal years 1991–1998 by year and sex.
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FIG. 3. Trends in acute appendicitis with perforation in Ontario per 100 000 population for the fiscal years 1991–1998 by year and sex.
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FIG. 4. Annual incidence of acute appendicitis in Ontario per 100 000 population for the fiscal years 1991–1998 by age group and sex. Diamonds = overall, squares = female, triangles = male (applies also to Figs. 5 and 6).
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FIG. 5. Annual incidence of acute appendicitis without perforation in Ontario per 100 000 population for the fiscal years 1991–1998 by age group and sex.
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FIG. 6. Annual incidence of acute appendicitis with perforation in Ontario per 100 000 population for the fiscal years 1991–1998 by age group and sex.
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FIG. 7. Age and sex-adjusted rates of acute appendicitis in Ontario per 100 000 population by month for the fiscal years 1991–1998. Diamonds = acute appendicitis, squares = nonperforated, triangles = perforated.
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References

    1. Liu CD, McFadden DW. Acute abdomen and appendix. In: Greenfield LJ, Mulholland MW, Zelenock GB, Oldham KT, Lillemoe KD, editors. Surgery: scientific principles and practice. 3rd ed. Philadelphia: Lippincott-Raven; 1997. p. 1246-61.
    1. Addiss DG, Shaffer N, Fowler BS, Tauxe RV. The epidemiology of appendicitis and appendectomy in the United States. Am J Epidemiol 1990;132:910-25. - PubMed
    1. Arnbjornsson E, Asp NG, Westin SI. Decreasing incidence of acute appendicitis, with special reference to the consumption of dietary fiber. Acta Chir Scand 1982;148:461-4. - PubMed
    1. McCahy P. Continuing fall in the incidence of acute appendicitis. Ann R Coll Surg Engl 1994;76:282-3. - PMC - PubMed
    1. Osman AA. Epidemiological study of appendicitis in Khartoum. Int Surg 1974;59:218-21. - PubMed