Acute appendicitis in the over-sixty age group.

Abstract

58 (37 per cent) of the 155 patients over the age of 60 years presenting with appendicitis at East Birmingham Hospital from 1970 to 1982 were found to have perforated appendices; the corresponding proportion under the age of 60 was 346 out of 3608 patients (10 per cent), the difference being statistically significant (P less than 0.001). The delay before surgery and the length of in-patient treatment were significantly longer in the group who perforated, and the mortality was greater, although not achieving significance. Examination of the yearly incidence reveals neither an increasing trend of appendicitis in elderly patients, nor an increase in the perforation rate over the period studied. Delay, at all stages, appears to be the major factor responsible for the higher rate of perforation in this age group; only by an increased awareness of appendicitis in the elderly can this risk be minimized.