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. 2016 Oct 27;8(10):693-699.
doi: 10.4240/wjgs.v8.i10.693.

Acute appendicitis: Epidemiology, treatment and outcomes- analysis of 16544 consecutive cases

Marco Ceresoli  1 , Alberto Zucchi  1 , Niccolò Allievi  1 , Asaf Harbi  1 , Michele Pisano  1 , Giulia Montori  1 , Arianna Heyer  1 , Gabriela E Nita  1 , Luca Ansaloni  1 , Federico Coccolini  1
Affiliations

Acute appendicitis: Epidemiology, treatment and outcomes- analysis of 16544 consecutive cases

Marco Ceresoli et al. World J Gastrointest Surg. .

Abstract

Aim: To investigate the epidemiology, treatment and outcomes of acute appendicitis (AA) in a large population study.

Methods: This is a retrospective cohort study derived from the administrative dataset of the Bergamo district healthcare system (more than 1 million inhabitants) from 1997 to 2013. Data about treatment, surgery, length of stay were collected. Moreover for each patients were registered data about relapse of appendicitis and hospital admission due to intestinal obstruction.

Results: From 1997 to 2013 in the Bergamo district we collected 16544 cases of AA, with a crude incidence rate of 89/100000 inhabitants per year; mean age was 24.51 ± 16.17, 54.7% were male and the mean Charlson's comorbidity index was 0.32 ± 0.92. Mortality was < 0.0001%. Appendectomy was performed in 94.7% of the patients and the mean length of stay was 5.08 ± 2.88 d; the cumulative hospital stay was 5.19 ± 3.36 d and 1.2% of patients had at least one further hospitalization due intestinal occlusion. Laparoscopic appendectomy was performed in 48% of cases. Percent of 5.34 the patients were treated conservatively with a mean length of stay of 3.98 ± 3.96 d; the relapse rate was 23.1% and the cumulative hospital stay during the study period was 5.46 ± 6.05 d.

Conclusion: The treatment of acute appendicitis in Northern Italy is slowly changing, with the large diffusion of laparoscopic approach; conservative treatment of non-complicated appendicitis is still a neglected option, but rich of promising results.

Keywords: Acute appendicitis; Conservative treatment; Epidemiology; Intestinal obstruction; Laparoscopic appendectomy.

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Conflict of interest statement

Conflict-of-interest statement: No potential conflicts of interest relevant to this article were reported.

Figures

Figure 1
Figure 1
Age class and sex distribution. 1: 0-1; 2: 1-6; 3: 7-13; 4: 14-17; 5: 18-25; 6: 26-35; 7: 36-45; 8: 46-55; 9: 56-65; 10: 66-75; 11: 76-85; 12: > 85.
Figure 2
Figure 2
Number of patients discharged with acute appendicitis diagnosis during the years.
Figure 3
Figure 3
Surgical technique during the years (A), between sex (B) and among age classes (C).
Figure 4
Figure 4
Cumulative length of stay between treatment options. Data are expressed in days (SD).
Figure 5
Figure 5
Kaplan-Meyer curve of failure of conservative treatment (blue line) and incidence of intestinal obstruction in operated patients (red line).
Figure 6
Figure 6
Treatment option during the years.
See this image and copyright information in PMC

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