The epidemiology of appendicitis and appendectomy in the United States.

Division of Bacterial Diseases, Center for Infectious Diseases, Centers for Disease Control, Atlanta, GA 30333.
American Journal of Epidemiology (Impact Factor: 4.98). 12/1990; 132(5):910-25.
Source: PubMed

ABSTRACT To describe the epidemiology of appendicitis and appendectomy in the United States, the authors analyzed National Hospital Discharge Survey data for the years 1979-1984. Approximately 250,000 cases of appendicitis occurred annually in the United States during this period, accounting for an estimated 1 million hospital days per year. The highest incidence of primary positive appendectomy (appendicitis) was found in persons aged 10-19 years (23.3 per 10,000 population per year); males had higher rates of appendicitis than females for all age groups (overall rate ratio, 1.4:1). Racial, geographic, and seasonal differences were also noted. Appendicitis rates were 1.5 times higher for whites than for nonwhites, highest (15.4 per 10,000 population per year) in the west north central region, and 11.3% higher in the summer than in the winter months. The highest rate of incidental appendectomy was found in women aged 35-44 years (43.8 per 10,000 population per year), 12.1 times higher than the rate for men of the same age. Between 1970 and 1984, the incidence of appendicitis decreased by 14.6%; reasons for this decline are unknown. A life table model suggests that the lifetime risk of appendicitis is 8.6% for males and 6.7% for females; the lifetime risk of appendectomy is 12.0% for males and 23.1% for females. Overall, an estimated 36 incidental procedures are performed to prevent one case of appendicitis; for the elderly, the preventive value of an incidental procedure is considerably lower.

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    ABSTRACT: Acute appendicitis is one of the most common indications for abdominal surgery in pediatrics with peak incidence in the second decade of life. Acute appendicitis in the first years of life is an uncommon event. The clinical presentation is often varied and the diagnosis may be overshadowed by other medical conditions. Gastroenteritis is the most common misdiagnosis, with a history of diarrhea present in 33% to 41% of patients. Pain is the most common presenting symptom in children less than 5 years old, followed by vomiting, fever, anorexia and diarrhea. The most common physical sign is focal tenderness (61% of the patients) followed by guarding (55%), diffuse tenderness (39%), rebound (32%), and mass (6%). Neonatal appendicitis is a very rare disease with high mortality; presenting symptoms are nonspecific with abdominal distension representing the main clinical presentation. The younger the patient, the earlier perforation occurs: 70% of patients less than 3 years develop a perforation within 48 h of onset of symptoms. A timely diagnosis reduces the risk of complications. We highlight the epidemiology, pathophysiology, clinical signs and laboratory clues of appendicitis in young children and suggest an algorithm for early diagnosis.
    05/2015; 4(2):19-24. DOI:10.5409/wjcp.v4.i2.19
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    DESCRIPTION: To determine the diagnostic values for computed tomography (CT) in acute appendicitis in different subgroups of patients presenting with right lower abdominal pain at emergency room (ER). This was a retrospective study on 226 patients (105 men and 121 women) with mean age of 44.0 ± 16.7 years (age range, 16-88 years) who presented with right lower abdominal pain at ER from January 2008 to December 2009. All were suspected of having acute appendicitis and underwent CT examinations before therapy was instituted. Their medical charts were reviewed for initial CT report, surgical report, pathology report and final diagnosis. Subgroup analyses of CT diagnostic values of acute appendicitis were performed in patients with different gender (men or women) and age (≤ 45 years or > 45 years). Of 226 patients, 114 (50.4%) had a final diagnosis of acute appendicitis. Overall, CT accuracy of acute appendicitis was 94.7%. In subgroup analyses, CT accuracy was 94.7% (men ≤ 45 years), 93.8% (men > 45 years), 97.1% (women ≤ 45 years), 92.5% (women > 45 years), respectively. The likelihood ratio (LR) of positive CT for acute appendicitis ranged from 37.7 in women ≤ 45 years to 7.0 in men > 45 years. Overall, CT diagnosis of acute appendicitis at ER is accurate. Women ≤ 45 years benefit most from preoperative CT because positive CT in this subgroup is associated with a large chance in the LR for appendicitis. However, in elderly patients, appendiceal tumors and chronic appendicitis may mimic acute appendicitis on CT scan.
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    ABSTRACT: Abdominal pain is a common symptom associated with transient disorders or serious disease. Diagnosing the cause of abdominal pain can be difficult, because many diseases can cause this symptom. One of the most common conditions associated with acute abdominal pain is acute appendicitis. Diagnosis is based on patient history and physical examination. The present study is based on a data set consisting of 516 children's medical records. Each record consists of 15 factors that are used in the routine clinical practice for the assessment of the acute appendicitis. The importance of these factors is examined in this paper, with the use of many Artificial Intelligence and classification methods. As a result, only 5 factors of the initial 15 factors can be used, in order to have equal or even better diagnosis.


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