Outcomes of acute appendicitis in elderly patients: a 5-year experience at a single institution

Year 2013, Volume: 2 Issue: 1, 40 - 46, 05.04.2013

Ali Gökakın , Mustafa Atabey Elif Uysal Köksal Deveci Ayhan Koyuncu Ömer Topçu

https://doi.org/10.12808/bcs.v2i1.22

Abstract

Abstract

Aim. Outcomes after elective surgical procedures are seemed as if similar in younger and older patients; however, urgent surgeries may cause significant morbidity and mortality in older patients. The aim of study was to present our management experience on acute appendicitis in elderly patient group. Methods. Patients who underwent appendectomy for acute appendicitis between 2007- 2012 were included in the study. Individuals with other reasons of acute abdomen not defined as acute appendicitis were excluded. With these criteria, 1382 patients were included in the study. Patients were divided into three age groups: group I; younger than 29, group II; 29 to 65, and group III; 65 and older. Variables selected for analysis included age, sex, duration of symptoms, duration of hospitalization (total and preoperative), operative approach, operative findings, operative time, morbidity and mortality rates, and pathological confirmation. Results. Duration of symptoms and hospitalization (total and preoperative) were higher in the group III. Post-operative outcomes were worse in the group III compared to the other groups. However, miss diagnosis rate was lower in that age group. Conclusions. Acute appendicitis in the elderly remains a challenge for practicing surgeons and continues to be associated with high morbidity. With increasing life expectancy, more such cases are likely to be encountered in the future.

Keywords: Appendicitis, aged, outcome

Özet

Amaç. Genç ve yaşlı hastalarda elektif cerrahi işlemlerin sonuçları benzer görülse de, yaşlılarda acil cerrahiler önemli morbidite ve mortaliteye yol açabilir. Bu çalışma yaşlı hasta grubunda akut apandisit yönetimindeki tecrübemizi sunmak amacıyla yapıldı. Yöntem. 2007-2012 yılları arasında akut apandisit nedeniyle apandektomi yapılan hastalar çalışmaya alındı. Diğer akut batın nedenleri saptanan olgular çalışma dışı tutuldu. Bu koşullara göre 1382 olgu çalışma kapsamında değerlendirildi. Çalışmaya alınan olgular üç yaş grubuna bölündü: grup I, yaş<29; grup II, yaş 29-65; ve grup III, 65 yaş ve üzeri. Yaş, cinsiyet, belirtilerin süresi, hastanede yatış süresi (toplam ve preoperatif), ameliyat tipi, bulguları ve ameliyat süresi, morbitite ve mortalite oranları ve patolojik bulguların uyumluluğu verileri değerlendirildi. Bulgular. Belirtilerin süresi ve hastanede yatış süresi (toplam ve preoperatif) grup III'de daha fazla bulundu. Postoperatif sonuçlar grup III olgularda diğer gruplara göre daha kötü bulundu; ama yanlış tanı oranı diğer gruplara göre daha düşüktü. Sonuçlar. Yaşlılarda akut apandisit cerrahi pratiğinin zor kısımlarından biridir ve daha yüksek morbidite ile birliktedir. Yaşam süresinin artması ile birlikte gelecekte bu olgularla daha fazla karşılaşılacağı beklenilmelidir.

Anahtar sözcükler: Apandisit, yaşlılık, klinik sonuç

Keywords

Appendicitis, aged, outcome

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