A new perspective in appendicitis: calculation of half time (T(1/2)) for perforation.
Appendicitis is generally a more serious disease in the elderly than in the young. In the former, perforation is seen commonly leading to the belief that the appendix perforates more readily and rapidly in the elderly. A competing view is that the appendix perforates relatively more frequently in the elderly than in the young. To distinguish between these two views we analyzed 126 cases of acute appendicitis stratified by age group. The time between onset of symptoms and perforation was calculated with a novel method that utilized the biological concept of T(1/2) for perforation. Our findings suggest that the rate of perforation in the elderly is not significantly different from that in the young but the frequency of perforation is higher in the elderly. We concluded that appendicitis carries a graver prognosis in the elderly because the frequency of appendiceal perforation is higher in the elderly.
Department of Surgery, The Johns Hopkins Medical Institutions, Balitmore, Maryland, USA.
J Mark
JM
Redmond
Gardner W
GW
Smith
Chumpon
C
Wilasrusmee
Dilip S
DS
Kittur
D000208:Acute Disease; D000328:Adult; D017668:Age of Onset; D000368:Aged; D001062:Appendectomy; D001064:Appendicitis / Q000150:complications* / Q000601:surgery; D006801:Humans; D007416:Intestinal Perforation / Q000209:etiology*; D012189:Retrospective Studies; D012422:Rupture, Spontaneous / Q000209:etiology; D013997:Time Factors