title: Mortality Related to Appendectomy; a Population Based Analysis over Two Decades in Finland.
abstract: To define the mortality rate of appendectomy patients and appendectomy-related risk factors.
  
  
  
  Appendectomy has been considered as a safe operation and negative appendectomies acceptable in order to avoid perforations. There are few publications on appendectomy-related mortality. Removal of a normal appendix has been suggested to be related to a higher mortality rate versus removal of an inflamed appendix.
  
  
  
  Data on all appendectomy patients between 1990 and 2010 in Finland were retrieved from the Discharge Register of the National Institute for Health and Welfare and combined with data from the Death Certificate Register of Statistics Finland. Thirty-day mortality was identified and compared with overall mortality. Detailed information from death certificates of patients dying within 30-day post-surgery was collected and analyzed.
  
  
  
  Over the study period, the thirty-day post-appendectomy mortality rate was 2.1/1000. Increased mortality was found in patients over 60 years of age. Negative appendectomy and complicated appendicitis were related to mortality. The negative appendectomy rate was higher in patients older than 40 years of age. During the study period, both mortality and the rate of negative appendectomies decreased, while the rate of laparoscopic appendectomies increased.
  
  
  
  Post-appendectomy mortality is related to both negative appendectomies and complicated appendicitis. Diagnostic accuracy is fundamental in the care of patients with acute appendicitis, especially in the elderly. Improved diagnostic accuracy may have reduced mortality over the last two decades in Finland.
authors.affiliation: Department of Gastroenterology and Alimentary Tract Surgery, Tampere University Hospital, Tampere, Finland.
authors.forename: Sannamari
authors.initials: S
authors.lastname: Kotaluoto
authors.affiliation: Department of Gastroenterology and Alimentary Tract Surgery, Tampere University Hospital, Tampere, Finland.
authors.forename: Mika
authors.initials: M
authors.lastname: Ukkonen
authors.affiliation: Emergency Division of Pirkanmaa Hospital District, Tampere University Hospital and University of Tampere, Tampere, Finland.
authors.forename: Satu-Liisa
authors.initials: SL
authors.lastname: Pauniaho
authors.affiliation: Science Center, Pirkanmaa Hospital District, Tampere and School of Health Sciences, University of Tampere, Tampere, Finland.
authors.forename: Mika
authors.initials: M
authors.lastname: Helminen
authors.affiliation: Department of Gastroenterology and Alimentary Tract Surgery, Tampere University Hospital, Tampere, Finland.
authors.forename: Juhani
authors.initials: J
authors.lastname: Sand
authors.affiliation: Department of Surgery, Kuopio University Hospital, Box 100, 70029 KYS, Kuopio, Finland. tuomora@gmail.com.
authors.forename: Tuomo
authors.initials: T
authors.lastname: Rantanen
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001062:Appendectomy / Q000401:mortality*; D001064:Appendicitis / Q000401:mortality / Q000601:surgery; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D055815:Young Adult