title: Acute appendicitis in the elderly in the twenty-first century.
abstract: BACKGROUND
  The incidence of appendicitis in the elderly has risen. Older age is an independent predictor of poor surgical outcome. Herein, we present the most comprehensive single institution study to describe the natural history and outcome of appendicitis in elderly patients.
  
  
  METHODS
  A review of 1898 consecutive patients who underwent appendectomy between 2004 and 2007 was performed. The elderly patients were defined as older than 68 years.
  
  
  RESULTS
  The median age of the entire cohort was 25 years, and 55% were males. The elderly group included 68 patients (3.6%). On comparison by age, the elderly group had a significantly longer delay from symptom onset to admission (50 vs. 31 h, P = 0.01) and from admission to surgery, a longer operative time and hospital stay, and higher rates of postoperative complications and complicated appendicitis.
  
  
  CONCLUSIONS
  The current study demonstrated several unique characteristics of the elderly population with acute appendicitis, which include poor outcome and longer time intervals to diagnosis and treatment. In order to improve the poor outcome of the elderly population with appendicitis, prospective trials are necessary.
authors: Department of Surgery, Chaim Sheba Medical Center, Tel Hashomer, Israel.
authors: Lior
authors: L
authors: Segev
authors: Andrei
authors: A
authors: Keidar
authors: Ilan
authors: I
authors: Schrier
authors: Shlomi
authors: S
authors: Rayman
authors: Nir
authors: N
authors: Wasserberg
authors: Eran
authors: E
authors: Sadot
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001062:Appendectomy; D001064:Appendicitis / Q000175:diagnosis / Q000453:epidemiology* / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D015994:Incidence; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult