Evolution of the Age Distribution and Mortality of Acute Appendicitis

• 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 as 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 avanced 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.

(Arch Surg 116:153-156, 1981)