Abstract
IntroductionThis paper presents an epidemiologic study of appendicitis in Taiwan over a twelve-year period. An analysis of the incidence in the low-income population (LIP) is included to explore the effects of lower socioeconomic status on appendicitis.MethodsWe analyzed the epidemiological features of appendicitis in Taiwan using data from the National Health Insurance Research Database (NHIRD) from 2000 to 2011. All cases diagnosed as appendicitis were enrolled.ResultsThe overall incidences of appendicitis, primary appendectomy, and perforated appendicitis were 107.76, 101.58, and 27.20 per 100,000 per year, respectively. The highest incidence of appendicitis was found in persons aged 15 to 29 years; males had higher rates of appendicitis than females at all ages except for 70 years and older. Appendicitis rates were 11.76 % higher in the summer than in the winter months. A multilevel analysis with hierarchical linear modeling (HLM) revealed that male patients, younger patients (aged ≤14 years), and elderly patients (aged ≥60 years) had a higher risk of perforated appendicitis; among adults, the incidence increased with age. Moreover, the risk of perforation was higher in patients with one or more comorbidities. LIP patients comprised 1.25 % of the total number of patients with appendicitis from 2000 to 2011. The overall incidence of appendicitis was 34.99 % higher in the LIP than in the normal population (NP), and the incidence of perforated appendicitis was 40.40 % higher in the LIP than in the NP. After multivariate adjustment, the adjusted hospital costs and length of hospital stay (LOS) for the LIP patients were higher than those for the NP patients.ConclusionsAppendicitis and appendectomy in Taiwan had similar overall incidences, seasonality patterns, and declining trends compared to numerous previous studies. Compared to NP patients, LIP patients had a higher risk of appendicitis, longer LOS and higher hospital costs as a result of appendectomy.
Highlights
This paper presents an epidemiologic study of appendicitis in Taiwan over a twelve-year period
Only a few studies have paid attention to the effect of socioeconomic status (SES) on appendicitis, studies focusing on the low-income population (LIP) [18]
The present study shows that the incidence of appendicitis in Taiwan is consistent with several previous studies on Western populations but lower than the reported value of a South Korean population
Summary
This paper presents an epidemiologic study of appendicitis in Taiwan over a twelve-year period. An analysis of the incidence in the low-income population (LIP) is included to explore the effects of lower socioeconomic status on appendicitis. No comprehensive study has evaluated the epidemiology of appendicitis in Taiwan from 2000 to 2011. Only a few studies have paid attention to the effect of socioeconomic status (SES) on appendicitis, studies focusing on the low-income population (LIP) [18]. We performed a comprehensive study to investigate the epidemiological features of age, gender, comorbidities, readmission, length of hospital stay (LOS), hospital cost, incidences, seasonal variation and the effect of lower SES on appendicitis and appendectomy. We compared the differences in adjusted costs and LOS for appendicitis between the LIP and normal population (NP). The data were retrieved from the National Health Insurance Research Database (NHIRD) for all years from 2000 to 2011
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