The amount of comorbidities as a single parameter has no effect in predicting the outcome in appendicitis patients older than 60 years

Abstract

Background: Retrospective analysis of acute appendicitis patients older than 60 and statistical evaluation of the association between the accompanying illnesses, severity of peritonitis, morbidity, and mortality rates.

Introduction: Although acute appendicitis is not frequent among aged populations, accompanying comorbidities of the geriatric patients are always fear factors before an emergency abdominal surgery even for acute appendicitis.

Methods: The data of the 27 patients older than 60 years who underwent appendectomy were retrospectively analyzed. The patients were grouped according to the total number of their comorbidities, Mannheim peritonitis index scores, and the period between the onset of abdominal pain and the admission to the hospital.

Results: The mean age of the patients was 73 years. The morbidity and mortality rates were statistically significantly higher in perforated cases. The comparison of patients with <or=1 comorbidity with patients with >or=2 comorbidities did not show any statistical difference in morbidity and mortality. The sensitivity, specificity, positive predictive value, and negative predictive values for mortality in geriatric acute appendicitis patients with Mannheim peritonitis index scores greater than 26 were found to be 75%, 86%, 50%, and 95%, respectively.

Discussion: Retrospective evaluation of geriatric patients with acute appendicitis, according to the total number of their comorbidities, surprisingly revealed no statistical difference between groups. We thought that a high Mannheim peritonitis index score is a more reliable criteria than the total number of comorbidities in predicting the prognosis of patients with acute appendicitis in the geriatric population.