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. 2020 Jul-Sep;24(3):e2020.00046.
doi: 10.4293/JSLS.2020.00046.

Appendicitis is a Severe Disease in Elderly Patients: A Twenty-Year Audit

Marthe Weinandt  1 , Gaelle Godiris-Petit  1 , Fabrice Menegaux  1 , Nathalie Chereau  1 , Renato Micelli Lupinacci  1
Affiliations

Appendicitis is a Severe Disease in Elderly Patients: A Twenty-Year Audit

Marthe Weinandt et al. JSLS. 2020 Jul-Sep.

Abstract

Background and objectives: Life expectancy has increased substantially. Elderly patients currently represent a large part of patients requiring emergency abdominal surgery. The aim of this study was to evaluate the postoperative outcomes of elderly patients who underwent appendectomy in a single French tertiary center.

Methods: We retrospectively reviewed the medical records of all patients who underwent appendectomy for acute appendicitis between January 1, 1994 and December 31, 2014. We used the French threshold of ≥ 75 y-old to define elderly patients. Hence, elderly patients who underwent appendectomy were compared to the younger group.

Results: During the study period, 2,060 consecutive patients underwent appendectomy for acute appendicitis. Laparoscopic appendectomy was performed in 52% of cases. Similar rates of laparoscopic approach were recorded in both groups, but conversion to open surgery was six times more frequent in elderly patients (17% vs. 3%; P < .0001). A higher incidence of complicated appendicitis was observed in the elderly group (63% vs. 13.6%; P < .0001). Complications occurred more frequently in the elderly group (46% vs. 8%; P < .0001). 30-d mortality was 0.15% for patients < 75 y and 6.15% for elderly patients (P < .0001). Unsuspected presence of an appendiceal neoplasm was higher (7.7%) in the elderly population.

Conclusion: This study highlights the fact that appendicitis in the elderly is associated with a higher rate of complicated appendicitis, morbidity, and mortality.

Keywords: Abscess; Acute appendicitis; Elderly; Mortality; Peritonitis.

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Conflict of interest statement

Conflicts of Interest: none.

Figures

Figure 1.
Figure 1.
Percentage of perforated appendicitis, overall complication rate and mortality by age.
See this image and copyright information in PMC

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