Article

Addiss DG, Shaffer N, Fowler BS, et al. 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: 5.23). 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.

Full-text preview

Available from: aspenbiopharma.com
  • Source
    • "Epidemiological studies indicate that approximately 12% of males and 23% of females undergo emergency appendectomy during their lifetime, while the true lifetime risk of developing appendicitis is only 9% and 7% for men and women, respectively[2]. Appendicitis is most common in patients aged 10-19 years[2]. The decision to perform a laparotomy and appendectomy is based on clinical findings only. "

    Preview · Article · Jan 2016
  • Source
    • "Epidemiological studies indicate that approximately 12% of males and 23% of females undergo emergency appendectomy during their lifetime, while the true lifetime risk of developing appendicitis is only 9% and 7% for men and women, respectively[2]. Appendicitis is most common in patients aged 10-19 years[2]. The decision to perform a laparotomy and appendectomy is based on clinical findings only. "

    Full-text · Article · Jan 2016
  • Source
    • "Complaints of abdominal pain account for 5% to 10% of all pediatric ED encounters [1] [2] [3] [4]. Appendicitis is the most common indication for emergency surgeries among children [5], and remains difficult to diagnose because of the similarity of symptoms with those of other illnesses [1] [6]. Missed or delayed diagnosis increases the risk of morbidity and mortality resulting from perforation of the appendix [3,6–8]. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Objective: To evaluate the cost-effectiveness of a diagnostic protocol for appendicitis in children, the use of a validated clinical decision rule (CDR) and a staged imaging protocol, compared with usual care. Methods: We estimated the cost-effectiveness of the three competing strategies using parameters from existing literature as well as a Markov model developed to simulate the effects of exposure to ionizing radiation from a single computed tomography (CT) study in the course of diagnosis. The simulation model was applied to a hypothetical cohort of 100,000 boys and girls, age 10 years, presenting with acute abdominal pain to emergency departments in the United States. Results: The integrated strategy, the CDR followed by staged imaging, was found to be the most cost-effective approach. Cost savings accrued from the reduction in CT utilization for low-risk patients compared with the other two strategies. The addition of ultrasound (US) to the CDR strategy reduced CT utilization by an additional 10.9%, its main cost advantage, with negligible change in net health benefits from false-negative US results, and associated morbidity or mortality. Conclusions: Results suggest that the integration of staged imaging with the CDR for the diagnosis of appendicitis in children is a cost-effective and cost-saving approach. The model estimates a further 10.9% reduction in the number of CTs from the incorporation of US for patients scoring high or medium risk, in excess of the 19.5% reduction estimated in the CDR validation study. © 2015 International Society for Pharmacoeconomics and Outcomes Research (ISPOR).
    Full-text · Article · Dec 2015 · Value in Health
Show more