Acute Appendicitis in Elderly Population a Study of the Various Risk Factors for Severity of Appendicitis

Abstract

Appendicitis in the elderly continues to be a challenging surgical problem. Being a potential life endangering pathology. It accounts for 5% of all acute abdominal condition in people aged more than 65 years .Mortality rates being 16 times more when compared to a young adult with appendicitis and complication rates like perforation being as high as to 70% as the disease presents with Vague symptoms and with a more virulent pathologic course that allows rapid progression of the disease which leads to delayed hospitalization, diagnosis, treatment and increased morbidity and mortality. Material and Methods - A 5 year retrospective cross sectional Chart review was done to collect information on patient’s above 60 years of age who had undergone appendicetomy .Demographic data , clinical presentation ,delay in hospital arrival and co morbid condition ,usg and intra operative findings noted and analysed Results:- Out of 111 elderly patients, 71 males and 40 females with a mean age of 69.8 years, 88 had hypertension,62 with diabetes , 19 ckd . 61 proved to have perforated appendicitis, 37 males and 24 females with significant delay in hospital arrival duration of 2-7 days .Perforation rates were increased in patients with multiple comorbities (diabetes, hypertension,ckd) and delay in hospital arrival. Conclusion: A high index of suspicion is needed in elderly patients with acute abdomen to prevent misdiagnosis. Delay in presentation to the hospital and multiple comorbidities are the main risk factors associated with higher rates of appendicular perforation.