TY - JOUR
T1 - Sex differences in the epidemiology, seasonal variation, and trends in the management of patients with acute appendicitis
AU - Stein, Gideon Y.
AU - Rath-Wolfson, Lea
AU - Zeidman, Aliza
AU - Atar, Eli
AU - Marcus, Ohad
AU - Joubran, Samia
AU - Ram, Edward
PY - 2012/10
Y1 - 2012/10
N2 - 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.
AB - 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.
KW - Acute appendicitis
KW - Appendectomy
KW - Computed tomography and ultrasound
KW - Epidemiology
KW - Gender
KW - Seasonal variations
UR - http://www.scopus.com/inward/record.url?scp=84868243063&partnerID=8YFLogxK
U2 - 10.1007/s00423-012-0958-0
DO - 10.1007/s00423-012-0958-0
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C2 - 22661078
AN - SCOPUS:84868243063
SN - 1435-2443
VL - 397
SP - 1087
EP - 1092
JO - Langenbeck's Archives of Surgery
JF - Langenbeck's Archives of Surgery
IS - 7
ER -