Appendicitis is a Severe Disease in Elderly Patients: A Twenty-Year Audit
Appendicitis is a Severe Disease in Elderly Patients: A Twenty-Year Audit
复制标题
DOI：
10.4293/jsls.2020.00046
复制
发表时间：
2020-07-01
影响因子：
1.5
通讯作者：
Lupinacci, Renato Micelli
中科院分区：
文献类型：
--
作者：
Weinandt, Marthe;Godiris-Petit, Gaelle;Lupinacci, Renato Micelli
背景和目的：预期寿命大幅度增加。老年患者目前代表了需要急诊腹部手术的患者的很大一部分。本研究的目的是评估老年患者谁接受了阑尾切除术在一个单一的法国三级center.Methods的术后结果：我们回顾性分析了1994年1月1日至2014年12月31日期间接受阑尾切除术的急性阑尾炎的所有患者的病历。我们使用法国阈值>= 75岁来定义老年患者。结果：在研究期间，2,060例连续的急性阑尾炎患者接受了阑尾切除术。52%的病例进行了腹腔镜阑尾切除术。两组的腹腔镜手术率相似，但老年患者转为开放手术的频率高出6倍（17%比3%; P <0.0001）。老年组中并发性阑尾炎的发生率较高（63% vs. 13.6%; P <0.0001）。老年组的并发症发生率更高（46% vs. 8%; P <0.0001）。< 75岁患者的30天死亡率为0.15%，老年患者为6.15%（P <0.0001）。意外存在的阑尾肿瘤是较高的（7.7%）在老年population.Conclusion：这项研究强调了这样一个事实，即阑尾炎在老年人是与较高的复杂性阑尾炎，发病率和死亡率。
Background and Objectives: Life expectancy has increased substantially. Elderly patients currently represent a large part of patients requiring emergency abdominal surgery. The aim of this study was to evaluate the postoperative outcomes of elderly patients who underwent appendectomy in a single French tertiary center.Methods: We retrospectively reviewed the medical records of all patients who underwent appendectomy for acute appendicitis between January 1, 1994 and December 31, 2014. We used the French threshold of >= 75 y-old to define elderly patients. I fence, elderly patients who underwent appendectomy were compared to the younger group.Results: During the study period, 2,060 consecutive patients underwent appendectomy for acute appendicitis. Laparoscopic appendectomy was performed in 52% of cases. Similar rates of laparoscopic approach were recorded in both groups, but conversion to open surgery was six times more frequent in elderly patients (17% vs. 3%; P < .0001). A higher incidence of complicated appendicitis was observed in the elderly group (63% vs. 13.6%; P < .0001). Complications occurred more frequently in the elderly group (46% vs. 8%; P < .0001). 30-d mortality was 0.15% for patients < 75 y and 6.15% for elderly patients (P < .0001). Unsuspected presence of an appendiceal neoplasm was higher (7.7%) in the elderly population.Conclusion: This study highlights the fact that appendicitis in the elderly is associated with a higher rate of complicated appendicitis, morbidity, and mortality.