title: Appendicitis in the elderly: what has changed?
abstract: BACKGROUND
  The course and outcome of appendicitis in the elderly differs from that of the general population. The rates of perforated appendices, error in diagnosis, postoperative complications and mortality may be related to the time lapse between onset of symptoms and admission, and hence delay in surgery.
  
  
  OBJECTIVE
  To evaluate if these factors have improved in recent years.
  
  
  METHODS
  A retrospective study was carried out of all 61 patients over age 60 who underwent appendectomies in a major metropolitan hospital during 1988-98.
  
  
  RESULTS
  We found that most patients had appendectomies within the first 24 hours of admission and within 3 days of symptoms. Rate of perforation was 43%, error 5.6%, morbidity 41%, and mortality 3.2%.
  
  
  CONCLUSIONS
  The high rate of appendix perforation in the elderly is not due to delay. The literature reveals little improvement in the statistics of the disease over the last five decades, despite advances in imaging and surgical technique. This may be explained by the increasing inclusion of octogenarian patients.
authors.affiliation: Department of Surgery B, Tel Aviv Sourasky Medical Center, Israel.
authors.forename: R
authors.initials: R
authors.lastname: Rub
authors.forename: D
authors.initials: D
authors.lastname: Margel
authors.forename: D
authors.initials: D
authors.lastname: Soffer
authors.forename: Y
authors.initials: Y
authors.lastname: Kluger
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001062:Appendectomy; D001064:Appendicitis / Q000150:complications / Q000175:diagnosis / Q000601:surgery; D005260:Female; D006801:Humans; D007416:Intestinal Perforation / Q000209:etiology; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012422:Rupture, Spontaneous