The team investigated the effect of computed tomography and laparoscopy on the outcome of elderly patients with appendicitis.
The findings of the study were published in the September issue of the Archives of Surgery.
A total of 95 patients, who underwent appendectomy for appendicitis between 1991 and 2000, were included in the retrospective review. All were aged 70 years and older.
The participants were divided into Groups 1 (those treated from 1991 to 1995, n = 47) and 2 (those treated from 1996 to 2000, n = 48).
Age, sex, preoperative evaluation, operative duration and findings, postoperative course, duration of hospital stay, and mortality rate, were all evaluated
The mean age (78 years) and sex were similar in both groups.
Preoperative suggestion of appendicitis (Group 1, 83% of patients; Group 2, 94%), and duration of the preoperative hospitalization over 24 hours (Group 1, 23%; Group 2, 19%) were also comparable.
| Increasing use of CT and laparoscopy for appendicitis in recent years.
| Archives of Surgery |
There was an increasing use of diagnostic computed tomography (Group 1, 28%; Group 2, 67%) and laparoscopy (Group 1, 30%; Group 2, 48%) between the 2 study periods.
However, this was associated with no significant difference in the duration of hospitalization, frequency of appendiceal perforation or abscess, occurrence of complications, or mortality.
The authors found that the length of operating time increased in the second period (1996 to 2000).
Dr Thomas T. Hui, of the Cedars-Sinai Medical Center, Los Angeles, said on behalf of his colleagues, "Appendicitis in elderly patients continues to be a challenging surgical problem."
"While computed tomography may represent a useful diagnostic tool and laparoscopic appendectomy may be appropriate therapy for selected patients, neither has affected outcome when measured for morbidity and mortality rates," he added.
"Overall results might improve with earlier consideration of the diagnosis in elderly patients with abdominal pain, followed by prompt surgical consultation and operation," he concluded.