Evolution of the age distribution and mortality of acute appendicitis
P. Peltokallio and H. Tykka
Death due to appendicitis is still a significant occurrence. The stage when
the disease is diagnosed and operation occurs has a decisive influence on
the mortality. In our series of 9,652 cases of appendicitis, 26 patients
died (0.27%)-ten (0.12%) of nonperforative appendicitis, and 16 (1.18%) of
perforative appendicitis. Both the patients and the physician can delay
treatment. The proportion of fatal cases is six times as great in
perforative appendicitis is in those operated on in time. The deaths in
those with a perforated appendix were usually caused by the basic disease
or the surgical procedure, while in patients with unperforated appendixes,
death was most commonly caused by other concomitant diseases. The
proportion of the elderly in our series increased along with the rise in
the average age of the population. The symptoms of acute appendicitis and
the clinical findings are identical in the elderly and in the younger
patients, but the disease in the aged advanced more rapidly to perforation
and the mortality among them was higher. Active and careful attention to
patients with possible diagnosis of appendicitis, especially in the
elderly, is important.
