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Surgery Research and Practice
Volume 2015, Article ID 847681, 6 pages
http://dx.doi.org/10.1155/2015/847681
Research Article

Factors Associated with Perforated Appendicitis in Elderly Patients in a Tertiary Care Hospital

Department of Surgery, Rajavithi Hospital, College of Medicine, Rangsit University, Phayathai Road, Rajathewee, Bangkok 10400, Thailand

Received 22 May 2015; Revised 3 August 2015; Accepted 10 August 2015

Academic Editor: Miltiadis I. Matsagkas

Copyright © 2015 Siripong Sirikurnpiboon and Suparat Amornpornchareon. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background. The incidence of perforated appendicitis in elderly patients is high and carries increased morbidity and mortality rates. The aim of this study was to identify risk factors of perforation in elderly patients who presented with clinical of acute appendicitis. Methods. This was a retrospective study, reviewing medical records of patients over the age of 60 years who had a confirmed diagnosis of acute appendicitis. Patients were classified into two groups: those with perforated appendicitis and those with nonperforated appendicitis. Demographic data, clinical presentations, and laboratory analysis were compared. Results. Of the 206 acute appendicitis patients over the age of 60 years, perforated appendicitis was found in 106 (50%) patients. The four factors which predicted appendiceal rupture were as follows: male; duration of pain in preadmission period; fever (>38°C); and anorexia. The overall complication rate was 34% in the perforation group and 12.6% in the nonperforation group. Conclusions. The incidence of perforated appendicitis in elderly patients was higher in males and those who had certain clinical features such as fever and anorexia. Duration of pain in the preadmission period was also an important factor in appendiceal rupture. Early diagnosis may decrease the incidence of perforated appendicitis in elderly patients.