Sex differences in the epidemiology, seasonal variation, and trends in the management of patients with acute appendicitis

Gideon Y. Stein, Lea Rath-Wolfson, Aliza Zeidman, Eli Atar, Ohad Marcus, Samia Joubran, Edward Ram

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Acute appendicitis is the most common indication for acute surgical abdominal intervention. In this study, we analyzed the gender correlation with demographic, epidemiologic, diurnal, and seasonal trends in relation to the incidence and management of patients with acute appendicitis in our medical center. Methods: Data of patients, 18 years of age or older who underwent emergency appendectomies at the Rabin Medical Center during the last 13 years, were collected. The data collected included demographic parameters, hospitalization, procedures, and use of preoperative imaging. Results: Data were available for 3,736 patients. Males had more appendicitis attacks than females (p<0.0001), whereas females had more normal appendixes than males (p<0.0001). The overall rate of normal appendixes was 19.6%, with a decline in the past 10 years from a yearly average of 23.5% between 1998 and 2002 to 15% between 2003 and 2007 (p<0.0001) with a reverse correlation with the preoperative use of abdominal CT. A distinct seasonal pattern was observed; more appendectomies for acute appendicitis occurred during the summer months (p<0.0001). Ten percent of patients had a complicated course with a mortality rate of 0.33%; most of them were elderly, male/female ratio 0.4. Conclusions: We found distinct gender, epidemiological, seasonal, and diurnal trends influencing the incidence of acute appendicitis. The incidence rate of false-positive surgery has been gradually declining, probably due to the increased use of preoperative abdominal CT and ultrasound. Acute appendicitis was more common in males and during the summer months.

Original languageEnglish
Pages (from-to)1087-1092
Number of pages6
JournalLangenbeck's Archives of Surgery
Volume397
Issue number7
DOIs
StatePublished - Oct 2012

Keywords

  • Acute appendicitis
  • Appendectomy
  • Computed tomography and ultrasound
  • Epidemiology
  • Gender
  • Seasonal variations

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