Comparison of Clinical Outcome of Acute Appendicitis in Elder Versus Young Patients

Abstract

Background: Acute appendicitis is a common surgical emergency, particularly affecting younger populations, but with significant clinical outcomes in the elderly. The diagnostic challenge and variation in clinical presentations necessitate a thorough understanding of age-specific outcomes.

Objective: To figure out the frequency of acute appendicitis among different age groups and compare the frequency of poor clinical outcomes in elderly versus young patients.

Methods: A cross-sectional study was conducted from March 15, 2023, to August 15, 2023, at the Combined Military Hospital, Peshawar. The study included 120 patients aged 10-80 years who underwent appendectomy for acute appendicitis under general anesthesia. Exclusion criteria were ASA 3 & IV, liver disease (ALT & AST >40 IU), hepatitis B or C, diabetes (BSR >200 mg/dl), and anemia (Hb <10 g/dl). Patients were stratified into two age groups: young (≤50 years) and older (>50 years). Data on demographics, clinical presentation, intraoperative findings, hospital stay, and postoperative complications were collected. Statistical analysis was performed using SPSS version 25, with significance set at p ≤0.05.

Results: Of the 120 patients, 65.83% were young adults, and 34.17% were older adults. Among the younger group, 1.27% had a prolonged hospital stay, compared to 26.83% in the older group. Perforated appendices were noted in 20.25% of younger patients versus 70.73% of older patients. Postoperative complications occurred in 6.17% of younger patients and 36.59% of older patients (p <0.05).

Conclusion: The frequency of acute appendicitis is higher in younger patients, but older patients experience significantly poorer clinical outcomes, including higher rates of perforation, prolonged hospital stay, and postoperative complications.