Materiały źródłowe

• #1 Appendicitis | Treatment & Management | Point of Care

  https://www.statpearls.com/point-of-care/17784

  Acute appendicitis commonly represents a significant proportion of acute abdominal conditions. It has an incidence rate ranging from 100 to 223 new cases per 100,000 individuals per year. In the United States alone, approximately 300,000 hospital visits are reported annually related to appendicitis. […] While acute appendicitis can occur at any age, it is most commonly observed in the age range of 5 to 45. This age distribution reflects the higher incidence of appendicitis during childhood, adolescence, and early adulthood. The mean age at presentation is 28. Overall, there is a slight preponderance of acute appendicitis in males compared to females. The lifetime incidence of acute appendicitis is 8.6% in males and 6.7% in females. However, it is important to note that appendicitis can occur in both sexes, and the difference in incidence between males and females is not substantial.

• #2 Appendicitis: Epidemiology, Evaluation, and Controversy in Management | IntechOpen

  https://www.intechopen.com/chapters/1132565

  Appendicitis is the most common acute general surgical emergency. […] The incidence of appendicitis is 712% in the population of the USA and Europe, and, stable in most western countries. […] The lifetime risk of developing acute appendicitis requiring surgery is ~7% which is maximal in childhood and declines steadily with increasing age as the lymphoid tissue and vascularity atrophy. […] The fact that increasing the dietary fiber in modern Western society can reduce the incidence of appendicitis, is demonstrated by the substantial fall over the last 30 years in Western countries. […] The prevalence has been more or less stable since the year 2000, at 151 per 100,000 person years within Western Europe and assumed to be secondary to improved living standards and general hygiene. […] Most deaths occur in the elderly because of rapid progression to gangrene, delayed diagnosis, and peritoneal sepsis compounding coincidental cardiovascular, respiratory, or renal pathology.

• #3 Appendicitis: Practice Essentials, Background, Anatomy

  https://emedicine.medscape.com/article/773895-overview

  Appendicitis is one of the more common surgical emergencies, and it is one of the most common causes of abdominal pain. In the United States, 250,000 cases of appendicitis are reported annually, representing 1 million patient-days of admission. The incidence of acute appendicitis has been declining steadily since the late 1940s, and the current annual incidence is 10 cases per 100,000 population. Appendicitis occurs in 7% of the US population, with an incidence of 1.1 cases per 1000 people per year. Some familial predisposition exists. […] In Asian and African countries, the incidence of acute appendicitis is probably lower because of the dietary habits of the inhabitants of these geographic areas. The incidence of appendicitis is lower in cultures with a higher intake of dietary fiber. Dietary fiber is thought to decrease the viscosity of feces, decrease bowel transit time, and discourage formation of fecaliths, which predispose individuals to obstructions of the appendiceal lumen.

• #4 The epidemiology of appendicitis and appendectomy in the United States – PubMed

  https://pubmed.ncbi.nlm.nih.gov/2239906/

  To describe the epidemiology of appendicitis and appendectomy in the United States, the authors analyzed National Hospital Discharge Survey data for the years 1979-1984. Approximately 250,000 cases of appendicitis occurred annually in the United States during this period, accounting for an estimated 1 million hospital days per year. The highest incidence of primary positive appendectomy (appendicitis) was found in persons aged 10-19 years (23.3 per 10,000 population per year); males had higher rates of appendicitis than females for all age groups (overall rate ratio, 1.4:1). […] Racial, geographic, and seasonal differences were also noted. Appendicitis rates were 1.5 times higher for whites than for nonwhites, highest (15.4 per 10,000 population per year) in the west north central region, and 11.3% higher in the summer than in the winter months.

• #5 Appendicitis | Treatment & Management | Point of Care

  https://www.statpearls.com/point-of-care/17784

  Acute appendicitis commonly represents a significant proportion of acute abdominal conditions. It has an incidence rate ranging from 100 to 223 new cases per 100,000 individuals per year. In the United States alone, approximately 300,000 hospital visits are reported annually related to appendicitis. […] While acute appendicitis can occur at any age, it is most commonly observed in the age range of 5 to 45. This age distribution reflects the higher incidence of appendicitis during childhood, adolescence, and early adulthood. The mean age at presentation is 28. Overall, there is a slight preponderance of acute appendicitis in males compared to females. The lifetime incidence of acute appendicitis is 8.6% in males and 6.7% in females. However, it is important to note that appendicitis can occur in both sexes, and the difference in incidence between males and females is not substantial.

• #6 Appendicitis: Practice Essentials, Background, Anatomy

  https://emedicine.medscape.com/article/773895-overview

  Appendicitis is one of the more common surgical emergencies, and it is one of the most common causes of abdominal pain. In the United States, 250,000 cases of appendicitis are reported annually, representing 1 million patient-days of admission. The incidence of acute appendicitis has been declining steadily since the late 1940s, and the current annual incidence is 10 cases per 100,000 population. Appendicitis occurs in 7% of the US population, with an incidence of 1.1 cases per 1000 people per year. Some familial predisposition exists. […] In Asian and African countries, the incidence of acute appendicitis is probably lower because of the dietary habits of the inhabitants of these geographic areas. The incidence of appendicitis is lower in cultures with a higher intake of dietary fiber. Dietary fiber is thought to decrease the viscosity of feces, decrease bowel transit time, and discourage formation of fecaliths, which predispose individuals to obstructions of the appendiceal lumen.

• #7

  https://link.springer.com/article/10.1007/s00268-021-06077-5

  This study aims to describe the worldwide epidemiology and changing disease trends of acute appendicitis (AA). […] Epidemiological data on the incidence of AA and deaths were collected from the Global Health Data Exchange repository from 1990 to 2019. […] In 2019, there were an estimated 17.7 million cases (incidence 228/100,000) with over 33,400 deaths (0.43/100,000). Both the absolute number and the incidence had increased from 1990 to 2019 (+38.8% and +11.4%, respectively). […] The mortality rate of AA is declining worldwide, while the incidence is increasing.

• #8 Appendicitis | Treatment & Management | Point of Care

  https://www.statpearls.com/point-of-care/17784

  Acute appendicitis commonly represents a significant proportion of acute abdominal conditions. It has an incidence rate ranging from 100 to 223 new cases per 100,000 individuals per year. In the United States alone, approximately 300,000 hospital visits are reported annually related to appendicitis. […] While acute appendicitis can occur at any age, it is most commonly observed in the age range of 5 to 45. This age distribution reflects the higher incidence of appendicitis during childhood, adolescence, and early adulthood. The mean age at presentation is 28. Overall, there is a slight preponderance of acute appendicitis in males compared to females. The lifetime incidence of acute appendicitis is 8.6% in males and 6.7% in females. However, it is important to note that appendicitis can occur in both sexes, and the difference in incidence between males and females is not substantial.

• #9 Acute Appendicitis: Review and Update | AAFP

  https://www.aafp.org/pubs/afp/issues/1999/1101/p2027.html

  Appendicitis is common, with a lifetime occurrence of 7 percent. […] Appendicitis is the most common acute surgical condition of the abdomen. Approximately 7 percent of the population will have appendicitis in their lifetime, with the peak incidence occurring between the ages of 10 and 30 years. […] The mortality rate in nonperforated appendicitis is less than 1 percent, but it may be as high as 5 percent or more in young and elderly patients, in whom diagnosis may often be delayed, thus making perforation more likely. […] Factors that increase the rate of perforation are delayed presentation to medical care, age extremes (young and old) and hidden location of appendix. […] Young children are unable to relate a history, often have abdominal pain from other causes and may have more nonspecific signs and symptoms. These factors contribute to a perforation rate as high as 50 percent in this group.

• #10 Appendicitis, Acute | 5-Minute Clinical Consult

  https://www.unboundmedicine.com/5minute/view/5-Minute-Clinical-Consult/816599/all/Appendicitis_Acute?q=Acute+Appendicitis%2C

  Predominant age: 10 to 30 years; rare in infancy; although uncommon, it can be more challenging to diagnose in elderly. […] Predominant sex: slight male predominance. Ages 10 to 30 years: male female (3:2). Age 30 years: male = female. […] Incidence: 1 case per 1,000 people per year. Lifetime incidence of 1 in every 15 people (7%). […] Most common extrauterine surgical emergency. Incidence similar in pregnancy. Higher rate of perforation; more likely to present with peritonitis.

• #11 Appendicitis | Treatment & Management | Point of Care

  https://www.statpearls.com/point-of-care/17784

  Acute appendicitis commonly represents a significant proportion of acute abdominal conditions. It has an incidence rate ranging from 100 to 223 new cases per 100,000 individuals per year. In the United States alone, approximately 300,000 hospital visits are reported annually related to appendicitis. […] While acute appendicitis can occur at any age, it is most commonly observed in the age range of 5 to 45. This age distribution reflects the higher incidence of appendicitis during childhood, adolescence, and early adulthood. The mean age at presentation is 28. Overall, there is a slight preponderance of acute appendicitis in males compared to females. The lifetime incidence of acute appendicitis is 8.6% in males and 6.7% in females. However, it is important to note that appendicitis can occur in both sexes, and the difference in incidence between males and females is not substantial.

• #12 Appendicitis: Practice Essentials, Background, Anatomy

  https://emedicine.medscape.com/article/773895-overview

  In the last few years, a decrease in frequency of appendicitis in Western countries has been reported, which may be related to changes in dietary fiber intake. In fact, the higher incidence of appendicitis is believed to be related to poor fiber intake in such countries. […] There is a slight male preponderance of 3:2 in teenagers and young adults; in adults, the incidence of appendicitis is approximately 1.4 times greater in men than in women. The incidence of primary appendectomy is approximately equal in both sexes. […] The incidence of appendicitis gradually rises from birth, peaks in the late teen years, and gradually declines in the geriatric years. The mean age when appendicitis occurs in the pediatric population is 6-10 years. Lymphoid hyperplasia is observed more often among infants and adults and is responsible for the increased incidence of appendicitis in these age groups. Younger children have a higher rate of perforation, with reported rates of 50-85%. The median age at appendectomy is 22 years. Although rare, neonatal and even prenatal appendicitis have been reported. Clinicians must maintain a high index of suspicion in all age groups.

• #13 The epidemiology of appendicitis and appendectomy in the United States – PubMed

  https://pubmed.ncbi.nlm.nih.gov/2239906/

  To describe the epidemiology of appendicitis and appendectomy in the United States, the authors analyzed National Hospital Discharge Survey data for the years 1979-1984. Approximately 250,000 cases of appendicitis occurred annually in the United States during this period, accounting for an estimated 1 million hospital days per year. The highest incidence of primary positive appendectomy (appendicitis) was found in persons aged 10-19 years (23.3 per 10,000 population per year); males had higher rates of appendicitis than females for all age groups (overall rate ratio, 1.4:1). […] Racial, geographic, and seasonal differences were also noted. Appendicitis rates were 1.5 times higher for whites than for nonwhites, highest (15.4 per 10,000 population per year) in the west north central region, and 11.3% higher in the summer than in the winter months.

• #14 Appendicitis, Acute | 5-Minute Clinical Consult

  https://www.unboundmedicine.com/5minute/view/5-Minute-Clinical-Consult/816599/all/Appendicitis_Acute?q=Acute+Appendicitis%2C

  Predominant age: 10 to 30 years; rare in infancy; although uncommon, it can be more challenging to diagnose in elderly. […] Predominant sex: slight male predominance. Ages 10 to 30 years: male female (3:2). Age 30 years: male = female. […] Incidence: 1 case per 1,000 people per year. Lifetime incidence of 1 in every 15 people (7%). […] Most common extrauterine surgical emergency. Incidence similar in pregnancy. Higher rate of perforation; more likely to present with peritonitis.

• #15 Pediatric Appendicitis: Practice Essentials, Anatomy, Pathophysiology

  https://emedicine.medscape.com/article/926795-overview

  Appendicitis has an incidence of 70,000 pediatric cases per year in the United States. The incidence between birth and age 4 years is 1-2 cases per 10,000 children per year. The incidence increases to 25 cases per 10,000 children per year between 10 and 17 years of age. Overall, 7% of people in the United States have their appendix removed during their lifetime. The male-to-female ratio is approximately 2:1. […] Appendicitis is much more common in developed countries. Although the reason for this discrepancy is unknown, potential risk factors include a diet low in fiber and high in sugar, family history, and infection. Gut flora and exposure to gastrointestinal infections have also been proposed as a hygiene theory of appendicitis. There may also be a role of the genetics of the host and the microbiome of the gut in the development of appendicitis and, possibly, with the risk of perforated appendicitis.

• #16 Pediatric Appendicitis: Practice Essentials, Anatomy, Pathophysiology

  https://emedicine.medscape.com/article/926795-overview

  Appendicitis has an incidence of 70,000 pediatric cases per year in the United States. The incidence between birth and age 4 years is 1-2 cases per 10,000 children per year. The incidence increases to 25 cases per 10,000 children per year between 10 and 17 years of age. Overall, 7% of people in the United States have their appendix removed during their lifetime. The male-to-female ratio is approximately 2:1. […] Appendicitis is much more common in developed countries. Although the reason for this discrepancy is unknown, potential risk factors include a diet low in fiber and high in sugar, family history, and infection. Gut flora and exposure to gastrointestinal infections have also been proposed as a hygiene theory of appendicitis. There may also be a role of the genetics of the host and the microbiome of the gut in the development of appendicitis and, possibly, with the risk of perforated appendicitis.

• #17 The epidemiology of appendicitis and appendectomy in the United States – PubMed

  https://pubmed.ncbi.nlm.nih.gov/2239906/

  To describe the epidemiology of appendicitis and appendectomy in the United States, the authors analyzed National Hospital Discharge Survey data for the years 1979-1984. Approximately 250,000 cases of appendicitis occurred annually in the United States during this period, accounting for an estimated 1 million hospital days per year. The highest incidence of primary positive appendectomy (appendicitis) was found in persons aged 10-19 years (23.3 per 10,000 population per year); males had higher rates of appendicitis than females for all age groups (overall rate ratio, 1.4:1). […] Racial, geographic, and seasonal differences were also noted. Appendicitis rates were 1.5 times higher for whites than for nonwhites, highest (15.4 per 10,000 population per year) in the west north central region, and 11.3% higher in the summer than in the winter months.

• #18 Appendicitis | 5-Minute Pediatric Consult

  https://peds.unboundmedicine.com/pedscentral/view/5-Minute-Pediatric-Consult/617106/all/Appendicitis?q=Diarrhea

  Most common surgical emergency of childhood […] Incidence rate (per 10,000 person-years): 2 in 0- to 4-year olds, 10 in 5- to 9-year olds, 15 in 10- to 14-year olds […] 293,000 admissions in the United States in 2010 […] 80,000 pediatric appendectomies per year in United States […] Most commonly seen in 2nd decade of life; 5% are aged 0 to 4 years old […] Affects boys more commonly than girls.

• #19 Appendicitis: Epidemiology, Evaluation, and Controversy in Management | IntechOpen

  https://www.intechopen.com/chapters/1132565

  Appendicitis is the most common acute general surgical emergency. […] The incidence of appendicitis is 712% in the population of the USA and Europe, and, stable in most western countries. […] The lifetime risk of developing acute appendicitis requiring surgery is ~7% which is maximal in childhood and declines steadily with increasing age as the lymphoid tissue and vascularity atrophy. […] The fact that increasing the dietary fiber in modern Western society can reduce the incidence of appendicitis, is demonstrated by the substantial fall over the last 30 years in Western countries. […] The prevalence has been more or less stable since the year 2000, at 151 per 100,000 person years within Western Europe and assumed to be secondary to improved living standards and general hygiene. […] Most deaths occur in the elderly because of rapid progression to gangrene, delayed diagnosis, and peritoneal sepsis compounding coincidental cardiovascular, respiratory, or renal pathology.

• #20 Acute Appendicitis: Review and Update | AAFP

  https://www.aafp.org/pubs/afp/issues/1999/1101/p2027.html

  Appendicitis is common, with a lifetime occurrence of 7 percent. […] Appendicitis is the most common acute surgical condition of the abdomen. Approximately 7 percent of the population will have appendicitis in their lifetime, with the peak incidence occurring between the ages of 10 and 30 years. […] The mortality rate in nonperforated appendicitis is less than 1 percent, but it may be as high as 5 percent or more in young and elderly patients, in whom diagnosis may often be delayed, thus making perforation more likely. […] Factors that increase the rate of perforation are delayed presentation to medical care, age extremes (young and old) and hidden location of appendix. […] Young children are unable to relate a history, often have abdominal pain from other causes and may have more nonspecific signs and symptoms. These factors contribute to a perforation rate as high as 50 percent in this group.

• #21

  https://journals.lww.com/annalsofsurgery/fulltext/2017/08000/the_global_incidence_of_appendicitis__a_systematic.8.aspx

  Appendicitis is a global disease. The incidence of appendicitis is stable in most Western countries. Data from newly industrialized countries is sparse, but suggests that appendicitis is rising rapidly. […] Understanding the global evolution of appendicitis in highly industrialized countries and in newly industrialized countries is necessary for planning healthcare resource utilization. […] The life-time risk of appendicitis is 1 in 15 in the United States. […] Appendicitis-related hospitalizations cost $3 billion in 1 year within the United States alone. […] The rising incidence of appendicitis in newly industrialized countries may indicate an outbreak of appendicitis outside Western countries. […] Thus, we conducted a systematic review of population-based studies reporting the incidence of appendicitis across the world, performed temporal trend analyses of incidence rates over the past century, and pooled incidence of appendicitis since the beginning of the 21st century.

• #22 Appendicitis | Treatment & Management | Point of Care

  https://www.statpearls.com/point-of-care/17784

  Acute appendicitis commonly represents a significant proportion of acute abdominal conditions. It has an incidence rate ranging from 100 to 223 new cases per 100,000 individuals per year. In the United States alone, approximately 300,000 hospital visits are reported annually related to appendicitis. […] While acute appendicitis can occur at any age, it is most commonly observed in the age range of 5 to 45. This age distribution reflects the higher incidence of appendicitis during childhood, adolescence, and early adulthood. The mean age at presentation is 28. Overall, there is a slight preponderance of acute appendicitis in males compared to females. The lifetime incidence of acute appendicitis is 8.6% in males and 6.7% in females. However, it is important to note that appendicitis can occur in both sexes, and the difference in incidence between males and females is not substantial.

• #23 The epidemiology of appendicitis and appendectomy in the United States – PubMed

  https://pubmed.ncbi.nlm.nih.gov/2239906/

  Between 1970 and 1984, the incidence of appendicitis decreased by 14.6%; reasons for this decline are unknown. A life table model suggests that the lifetime risk of appendicitis is 8.6% for males and 6.7% for females; the lifetime risk of appendectomy is 12.0% for males and 23.1% for females. Overall, an estimated 36 incidental procedures are performed to prevent one case of appendicitis; for the elderly, the preventive value of an incidental procedure is considerably lower.

• #24 The Epidemiology of Appendicitis and Appendectomy in South Korea: National Registry Data

  https://www.jstage.jst.go.jp/article/jea/20/2/20_JE20090011/_article

  Appendicitis is one of the most frequent acute surgical conditions of the abdomen, and appendectomy is one of the most commonly performed operations in the world. […] We analyzed the epidemiological features and lifetime risk of appendicitis and appendectomy in South Korea using data collected for the national health insurance database from 2005 through 2007. […] The overall incidences of appendicitis, total appendectomy, and perforated appendectomy were 22.71, 13.56, and 2.91 per 10 000 population per year, respectively. […] The incidence of appendicitis and appendectomy showed clear seasonality, with a peak in summer. […] The standardized lifetime risks of appendicitis and appendectomy were constant from 2005 through 2007. […] A life table model suggests that the lifetime risk of appendicitis is 16.33% for males and 16.34% for females, and that the lifetime risk of appendectomy is 9.89% for males and 9.61% for females. […] As compared to results obtained in research on Western populations, appendicitis and appendectomy had a similar perforation rate and seasonality, but a higher overall incidence, in South Koreans. […] Between 2005 and 2007, the incidence of appendicitis and appendectomy was constant.

• #25 The epidemiology of appendicitis and appendectomy in the United States – PubMed

  https://pubmed.ncbi.nlm.nih.gov/2239906/

  Between 1970 and 1984, the incidence of appendicitis decreased by 14.6%; reasons for this decline are unknown. A life table model suggests that the lifetime risk of appendicitis is 8.6% for males and 6.7% for females; the lifetime risk of appendectomy is 12.0% for males and 23.1% for females. Overall, an estimated 36 incidental procedures are performed to prevent one case of appendicitis; for the elderly, the preventive value of an incidental procedure is considerably lower.

• #26

  https://journals.lww.com/annalsofsurgery/fulltext/2017/08000/the_global_incidence_of_appendicitis__a_systematic.8.aspx

  In Western countries, appendicitis has mostly stabilized during the latter portion of the 20th century. In Northern America the incidence is 100 per 100,000 person-years with nearly 400,000 diagnoses in 2015. In contrast, incidence is increasing in newly industrialized countries of Asia, the Middle East, Southern America, and Africa. […] Since 2000, the incidences of appendicitis in countries in Asia, Southern America, and the Middle East are higher than in many Western countries. […] Our systematic review suggests that newly industrialized countries, societies that have undergone rapid economic advancement, are experiencing an upswing in the incidence of appendicitis. […] Newly industrialized countries with high and rising incidence of appendicitis need to prepare their clinical infrastructure to rapidly diagnose and manage appendicitis or otherwise risk unnecessary morbidity and mortality.

• #27 The global, regional, and national burden of appendicitis in 204 countries and territories, 1990–2019: a systematic analysis from the Global Burden of Disease Study 2019 | BMC Gastroenterology | Full Text

  https://bmcgastroenterol.biomedcentral.com/articles/10.1186/s12876-023-02678-7

  Appendicitis remains a major public health challenge globally. Increasing awareness of appendicitis and its risk factors and the importance of early diagnosis and treatment is warranted to reduce its the burden. […] The incidence of appendicitis is approximately 233 per 100,000 population per year, with a lifetime incidence risk ranging from 6.7 to 8.6%. […] Although Western countries have reported a decrease in its incidence in the mid-twentieth century, newly industrialized countries have shown an increasing trend in the twenty-first century. […] The latest study reported the global incidence and mortality from appendicitis using data from the (Global Burden of Disease Study) [GBD], but the 21 GBD regions and 204 countries were not analyzed in this study; in addition, prevalence and YLDs were unavailable from this study.

• #28

  https://journals.lww.com/annalsofsurgery/fulltext/2017/08000/the_global_incidence_of_appendicitis__a_systematic.8.aspx

  We compared the incidence of appendicitis or appendectomy across the world and evaluated temporal trends. […] Population-based studies reported the incidence of appendicitis. […] The search retrieved 10,247 citations with 120 studies reporting on the incidence of appendicitis or appendectomy. During the 21st century the pooled incidence of appendicitis or appendectomy (in per 100,000 person-years) was 100 (95% CI: 91, 110) in Northern America, and the estimated number of cases in 2015 was 378,614. The pooled incidence ranged from 105 in Eastern Europe to 151 in Western Europe. […] In Western countries, the incidence of appendectomy steadily decreased since 1990 (APC after 1989=1.54; 95% CI: 2.22, 0.86), whereas the incidence of appendicitis stabilized (APC=0.36; 95% CI: 0.97, 0.26) for both perforated (APC=0.95; 95% CI: 0.25, 2.17) and nonperforated appendicitis (APC=0.44; 95% CI: 0.84, 1.73). In the 21st century, the incidence of appendicitis or appendectomy is high in newly industrialized countries in Asia (South Korea pooled: 206), the Middle East (Turkey pooled: 160), and Southern America (Chile: 202).

• #29

  https://journals.lww.com/annalsofsurgery/fulltext/2017/08000/the_global_incidence_of_appendicitis__a_systematic.8.aspx

  We compared the incidence of appendicitis or appendectomy across the world and evaluated temporal trends. […] Population-based studies reported the incidence of appendicitis. […] The search retrieved 10,247 citations with 120 studies reporting on the incidence of appendicitis or appendectomy. During the 21st century the pooled incidence of appendicitis or appendectomy (in per 100,000 person-years) was 100 (95% CI: 91, 110) in Northern America, and the estimated number of cases in 2015 was 378,614. The pooled incidence ranged from 105 in Eastern Europe to 151 in Western Europe. […] In Western countries, the incidence of appendectomy steadily decreased since 1990 (APC after 1989=1.54; 95% CI: 2.22, 0.86), whereas the incidence of appendicitis stabilized (APC=0.36; 95% CI: 0.97, 0.26) for both perforated (APC=0.95; 95% CI: 0.25, 2.17) and nonperforated appendicitis (APC=0.44; 95% CI: 0.84, 1.73). In the 21st century, the incidence of appendicitis or appendectomy is high in newly industrialized countries in Asia (South Korea pooled: 206), the Middle East (Turkey pooled: 160), and Southern America (Chile: 202).

• #30 Global burden of appendicitis in 204 countries & territories | CLEP

  https://www.dovepress.com/the-global-burden-of-appendicitis-in-204-countries-and-territories-fro-peer-reviewed-fulltext-article-CLEP

  The burden of incidence and DALYs were higher for women globally. The Wilcoxon test showed significant differences between sexes in the global incidence burden of numbers and rates among different age groups. […] In 2019, the highest ASIRs were observed in Andean Latin America, high-income Asia Pacific, and Central Latin America. The lowest ASIRs were observed in Oceania, Western Sub-Saharan Africa, and Eastern Sub-Saharan Africa. […] The top three countries in terms of appendicitis ASIR in 2019 were Bangladesh, Bhutan, and Peru. In contrast, Ethiopia, Kenya, and Indonesia had the lowest ASIRs in 2019. […] Overall, a slightly positive correlation was found between ASIR and SDI in global regions from 1990 to 2019, while a prominent negative correlation was observed between age-standardized DALY rates and SDI.

• #31 Global burden of appendicitis in 204 countries & territories | CLEP

  https://www.dovepress.com/the-global-burden-of-appendicitis-in-204-countries-and-territories-fro-peer-reviewed-fulltext-article-CLEP

  The burden of incidence and DALYs were higher for women globally. The Wilcoxon test showed significant differences between sexes in the global incidence burden of numbers and rates among different age groups. […] In 2019, the highest ASIRs were observed in Andean Latin America, high-income Asia Pacific, and Central Latin America. The lowest ASIRs were observed in Oceania, Western Sub-Saharan Africa, and Eastern Sub-Saharan Africa. […] The top three countries in terms of appendicitis ASIR in 2019 were Bangladesh, Bhutan, and Peru. In contrast, Ethiopia, Kenya, and Indonesia had the lowest ASIRs in 2019. […] Overall, a slightly positive correlation was found between ASIR and SDI in global regions from 1990 to 2019, while a prominent negative correlation was observed between age-standardized DALY rates and SDI.

• #32 The global, regional, and national burden of appendicitis in 204 countries and territories, 1990–2019: a systematic analysis from the Global Burden of Disease Study 2019 | BMC Gastroenterology | Full Text

  https://bmcgastroenterol.biomedcentral.com/articles/10.1186/s12876-023-02678-7

  To date, the incidence, prevalence, and YLD and association with the sociodemographic index (SDI) in all countries have not been analyzed. […] In the present study, we report the prevalence, incidence, and YLD of appendicitis in the general population in 204 countries and territories at the global, regional, and national levels in terms of the number and age-standardized rates stratified by age, sex, and SDI from 1990 to 2019. […] The global age-standardized YLD rate showed a steady trend from 1990 to 1997, and then increased from 1998 to 2019. […] The percentage change in the age-standardized prevalence rates varied across the 21 GBD regions from 1990 to 2019. […] The largest increases were observed in Ethiopia (176.1% [95% UI 150.9 to 207.1%]), India (98.4% [95% UI 91.2 to 106.2%]) and Nigeria (96.3% [95% UI 90.2 to 104.1%]).

• #33 The epidemiology of appendicitis and appendectomy in the United States – PubMed

  https://pubmed.ncbi.nlm.nih.gov/2239906/

  To describe the epidemiology of appendicitis and appendectomy in the United States, the authors analyzed National Hospital Discharge Survey data for the years 1979-1984. Approximately 250,000 cases of appendicitis occurred annually in the United States during this period, accounting for an estimated 1 million hospital days per year. The highest incidence of primary positive appendectomy (appendicitis) was found in persons aged 10-19 years (23.3 per 10,000 population per year); males had higher rates of appendicitis than females for all age groups (overall rate ratio, 1.4:1). […] Racial, geographic, and seasonal differences were also noted. Appendicitis rates were 1.5 times higher for whites than for nonwhites, highest (15.4 per 10,000 population per year) in the west north central region, and 11.3% higher in the summer than in the winter months.

• #34 Appendicitis epidemiology and demographics – wikidoc

  https://www.wikidoc.org/index.php/Appendicitis_epidemiology_and_demographics

  Appendicitis is one of the most prominent causes of acute abdominal pain. It is a common disease in both Europe and America, and each year, approximately 100 people per 100,000 exhibit developing cases of appendicitis. Younger people, in the age group of 10-19, have a higher chance of developing appendicitis. Males are more likely than females to develop appendicitis. Caucasians are more likely to develop appendicitis than non-Caucasians. […] In Europe and America, the incidence of appendicitis is about 100 per 100,000 patients per year. […] The peak incidence occurs between the second and third decades of life. […] In the United States, the highest incidence of appendicitis is found in the age group of 10-19 years old. […] Appendicitis rates are 1.5 times higher in Caucasians than in other ethnicities.

• #35

  https://journals.lww.com/epidem/fulltext/1991/09000/the_epidemiology_of_acute_appendicitis_in.3.aspx

  The incidence of acute appendicitis has been reported to vary substantially by country, geographic region, race, sex, season, and occupation, but the reasons for this variation are unknown. […] Comparison of age and sex-specific incidence rates for four racial/ethnic groups (white, Hispanic, black, and Asian/other) revealed rates in blacks and the Asian/other group one-half or less of the rates for whites and Hispanics between the ages of 5 and 29 years. […] Incidence rates in males were higher than rates in females in all racial/ethnic groups for most ages (RR = 1.11.7). […] Seasonal variation in incidence was modest. Peak rates occurred in July, August, and September, and the lowest rates occurred in December. […] Hypotheses about the etiology of appendicitis must account for substantial racial/ethnic, gender, age variation, and modest seasonal variation in the incidence.

• #36

  https://journals.lww.com/annalsofsurgery/fulltext/2017/08000/the_global_incidence_of_appendicitis__a_systematic.8.aspx

  In Western countries, appendicitis has mostly stabilized during the latter portion of the 20th century. In Northern America the incidence is 100 per 100,000 person-years with nearly 400,000 diagnoses in 2015. In contrast, incidence is increasing in newly industrialized countries of Asia, the Middle East, Southern America, and Africa. […] Since 2000, the incidences of appendicitis in countries in Asia, Southern America, and the Middle East are higher than in many Western countries. […] Our systematic review suggests that newly industrialized countries, societies that have undergone rapid economic advancement, are experiencing an upswing in the incidence of appendicitis. […] Newly industrialized countries with high and rising incidence of appendicitis need to prepare their clinical infrastructure to rapidly diagnose and manage appendicitis or otherwise risk unnecessary morbidity and mortality.

• #37 Thieme E-Journals – Zentralblatt für Chirurgie / Abstract

  https://doi.org/10.1055%2Fs-0030-1247477

  Die Appendizitis ist die hufigste Ursache fr ein akutes Abdomen. Jhrlich werden ca. 135000 Patienten in Deutschland appendektomiert. Die akute Appendizitis zeigt Vernderungen in der Epidemiologie, der Diagnostik und der Therapie. Die Epidemiologie weist eine weiter anhaltende rcklufige Inzidenz fr die akute nicht perforierte Appendizitis auf. Die Inzidenz der perforierten Appendizitis ist trotz Laparoskopie und bildgebender Diagnostik konstant geblieben. […] Epidemiological data indicate a continuing decrease in the incidence of acute non-perforated appendicitis. The incidence of perforated appendicitis has remained constant despite laparoscopy and imaging diagnostics. […] The increase of imaging diagnostics does not correlate with a decrease in the incidence of perforated appendicitis. Laparoscopic appendectomy has developed as a dominant method for operative therapy.

• #38 The epidemiology of appendicitis and appendectomy in the United States – PubMed

  https://pubmed.ncbi.nlm.nih.gov/2239906/

  Between 1970 and 1984, the incidence of appendicitis decreased by 14.6%; reasons for this decline are unknown. A life table model suggests that the lifetime risk of appendicitis is 8.6% for males and 6.7% for females; the lifetime risk of appendectomy is 12.0% for males and 23.1% for females. Overall, an estimated 36 incidental procedures are performed to prevent one case of appendicitis; for the elderly, the preventive value of an incidental procedure is considerably lower.

• #39 The Epidemiology of Appendicitis and Appendectomy in South Korea: National Registry Data

  https://www.jstage.jst.go.jp/article/jea/20/2/20_JE20090011/_article/-char/ja/

  Appendicitis is one of the most frequent acute surgical conditions of the abdomen, and appendectomy is one of the most commonly performed operations in the world. […] However, epidemiological data on appendicitis have not been reported for South Korean or East Asian populations. […] We analyzed the epidemiological features and lifetime risk of appendicitis and appendectomy in South Korea using data collected for the national health insurance database from 2005 through 2007. […] Appendectomy was performed in 59.70% of inpatients diagnosed with appendicitis. The overall incidences of appendicitis, total appendectomy, and perforated appendectomy were 22.71, 13.56, and 2.91 per 10 000 population per year, respectively. […] The incidence of appendicitis and appendectomy showed clear seasonality, with a peak in summer.

• #40 Summer Appendicitis

  https://www.amhsr.org/articles/summer-appendicitis.html

  Acute appendicitis has been reported to be present throughout the year, but some particular months are associated with higher incidences. […] A seasonal pattern of appendicitis with a mostly predominant peak is seen during the summer months in all the countries (except Nigeria and Turkey). Appendicitis is more common in summer months. […] The present study was aimed to verify the possible existence of seasonal variability in the onset of acute appendicitis in various parts of the world, by describing intensively the data available on the incidence of appendicitis during specific seasons of the year and by summarizing the critical sequences that need to be expressed for clinical presentations of appendicitis at the different periods of the year. […] Comprehensive results from these studies show that the appendicitis in most of the countries included in this review reflect a summer peak, only two studies from Turkey and Nigeria was noted the high number of hospital admission for appendicitis in winter months.

• #41 The epidemiology of appendicitis and appendectomy in the United States – PubMed

  https://pubmed.ncbi.nlm.nih.gov/2239906/

  To describe the epidemiology of appendicitis and appendectomy in the United States, the authors analyzed National Hospital Discharge Survey data for the years 1979-1984. Approximately 250,000 cases of appendicitis occurred annually in the United States during this period, accounting for an estimated 1 million hospital days per year. The highest incidence of primary positive appendectomy (appendicitis) was found in persons aged 10-19 years (23.3 per 10,000 population per year); males had higher rates of appendicitis than females for all age groups (overall rate ratio, 1.4:1). […] Racial, geographic, and seasonal differences were also noted. Appendicitis rates were 1.5 times higher for whites than for nonwhites, highest (15.4 per 10,000 population per year) in the west north central region, and 11.3% higher in the summer than in the winter months.

• #42 The epidemiology of appendicitis and appendectomy in the United States – PubMed

  https://pubmed.ncbi.nlm.nih.gov/2239906/

  To describe the epidemiology of appendicitis and appendectomy in the United States, the authors analyzed National Hospital Discharge Survey data for the years 1979-1984. Approximately 250,000 cases of appendicitis occurred annually in the United States during this period, accounting for an estimated 1 million hospital days per year. The highest incidence of primary positive appendectomy (appendicitis) was found in persons aged 10-19 years (23.3 per 10,000 population per year); males had higher rates of appendicitis than females for all age groups (overall rate ratio, 1.4:1). […] Racial, geographic, and seasonal differences were also noted. Appendicitis rates were 1.5 times higher for whites than for nonwhites, highest (15.4 per 10,000 population per year) in the west north central region, and 11.3% higher in the summer than in the winter months.

• #43

  https://journals.lww.com/epidem/fulltext/1991/09000/the_epidemiology_of_acute_appendicitis_in.3.aspx

  The incidence of acute appendicitis has been reported to vary substantially by country, geographic region, race, sex, season, and occupation, but the reasons for this variation are unknown. […] Comparison of age and sex-specific incidence rates for four racial/ethnic groups (white, Hispanic, black, and Asian/other) revealed rates in blacks and the Asian/other group one-half or less of the rates for whites and Hispanics between the ages of 5 and 29 years. […] Incidence rates in males were higher than rates in females in all racial/ethnic groups for most ages (RR = 1.11.7). […] Seasonal variation in incidence was modest. Peak rates occurred in July, August, and September, and the lowest rates occurred in December. […] Hypotheses about the etiology of appendicitis must account for substantial racial/ethnic, gender, age variation, and modest seasonal variation in the incidence.

• #44

  https://he01.tci-thaijo.org/index.php/PSUMJ/article/view/264804

  Objective: The study aimed to study the spatiotemporal distribution of acute appendicitis in Thailand, using a reimbursement dataset from the National Health Security Office, and also analyze for mortality and factors associated with mortality after an appendectomy. […] The analysis looked for the incidence trend and seasonal variation of the incidence. […] A prediction model for mortality was constructed using a decision tree. […] During the 4 fiscal years of the study period, from October 2016 – September 2020, a total of 287,449 individuals were diagnosed with acute appendicitis, and 272,850 appendectomies were performed, which gave an annual incidence (AI) of 10.8/10,000 person-years. […] Using a multiplicative model of time series detrending and a decomposition model and a seasonal variation of acute appendicitis, with the highest incidence from May to October, linear regression showed a significant correlation between the incidence of appendicitis and precipitation (r2=0.28, p-value0.001).

• #45 Pediatric Appendicitis: Practice Essentials, Anatomy, Pathophysiology

  https://emedicine.medscape.com/article/926795-overview

  Appendicitis has an incidence of 70,000 pediatric cases per year in the United States. The incidence between birth and age 4 years is 1-2 cases per 10,000 children per year. The incidence increases to 25 cases per 10,000 children per year between 10 and 17 years of age. Overall, 7% of people in the United States have their appendix removed during their lifetime. The male-to-female ratio is approximately 2:1. […] Appendicitis is much more common in developed countries. Although the reason for this discrepancy is unknown, potential risk factors include a diet low in fiber and high in sugar, family history, and infection. Gut flora and exposure to gastrointestinal infections have also been proposed as a hygiene theory of appendicitis. There may also be a role of the genetics of the host and the microbiome of the gut in the development of appendicitis and, possibly, with the risk of perforated appendicitis.

• #46 Appendicitis: Practice Essentials, Background, Anatomy

  https://emedicine.medscape.com/article/773895-overview

  Appendicitis is one of the more common surgical emergencies, and it is one of the most common causes of abdominal pain. In the United States, 250,000 cases of appendicitis are reported annually, representing 1 million patient-days of admission. The incidence of acute appendicitis has been declining steadily since the late 1940s, and the current annual incidence is 10 cases per 100,000 population. Appendicitis occurs in 7% of the US population, with an incidence of 1.1 cases per 1000 people per year. Some familial predisposition exists. […] In Asian and African countries, the incidence of acute appendicitis is probably lower because of the dietary habits of the inhabitants of these geographic areas. The incidence of appendicitis is lower in cultures with a higher intake of dietary fiber. Dietary fiber is thought to decrease the viscosity of feces, decrease bowel transit time, and discourage formation of fecaliths, which predispose individuals to obstructions of the appendiceal lumen.

• #47 Appendicitis: Practice Essentials, Background, Anatomy

  https://emedicine.medscape.com/article/773895-overview

  Appendicitis is one of the more common surgical emergencies, and it is one of the most common causes of abdominal pain. In the United States, 250,000 cases of appendicitis are reported annually, representing 1 million patient-days of admission. The incidence of acute appendicitis has been declining steadily since the late 1940s, and the current annual incidence is 10 cases per 100,000 population. Appendicitis occurs in 7% of the US population, with an incidence of 1.1 cases per 1000 people per year. Some familial predisposition exists. […] In Asian and African countries, the incidence of acute appendicitis is probably lower because of the dietary habits of the inhabitants of these geographic areas. The incidence of appendicitis is lower in cultures with a higher intake of dietary fiber. Dietary fiber is thought to decrease the viscosity of feces, decrease bowel transit time, and discourage formation of fecaliths, which predispose individuals to obstructions of the appendiceal lumen.

• #48 THE EPIDEMIOLOGY OF CHILDHOOD APPENDICITIS: A CASE-CONTROL STUDY | Pediatric Research

  https://www.nature.com/articles/pr1984607

  A significant protective effect was demonstrated between intake of cereal fiber in the upper 50th percentile and risk of appendicitis (relative risk: 0.53, p 0.05). […] A significant „dose-response” effect was also noted between increasing levels of whole-grain cereal intake and decreasing risk of appendicitis (p = 0.024). […] The roles of birthweight, growth indices, allergies, laxatives, and constipation were also investigated, and none of these factors was associated with childhood appendicitis.

• #49 Appendicitis: Epidemiology, Evaluation, and Controversy in Management | IntechOpen

  https://www.intechopen.com/chapters/1132565

  Appendicitis is the most common acute general surgical emergency. […] The incidence of appendicitis is 712% in the population of the USA and Europe, and, stable in most western countries. […] The lifetime risk of developing acute appendicitis requiring surgery is ~7% which is maximal in childhood and declines steadily with increasing age as the lymphoid tissue and vascularity atrophy. […] The fact that increasing the dietary fiber in modern Western society can reduce the incidence of appendicitis, is demonstrated by the substantial fall over the last 30 years in Western countries. […] The prevalence has been more or less stable since the year 2000, at 151 per 100,000 person years within Western Europe and assumed to be secondary to improved living standards and general hygiene. […] Most deaths occur in the elderly because of rapid progression to gangrene, delayed diagnosis, and peritoneal sepsis compounding coincidental cardiovascular, respiratory, or renal pathology.

• #50

  https://journals.lww.com/annalsofsurgery/fulltext/2017/08000/the_global_incidence_of_appendicitis__a_systematic.8.aspx

  In Western countries, appendicitis has mostly stabilized during the latter portion of the 20th century. In Northern America the incidence is 100 per 100,000 person-years with nearly 400,000 diagnoses in 2015. In contrast, incidence is increasing in newly industrialized countries of Asia, the Middle East, Southern America, and Africa. […] Since 2000, the incidences of appendicitis in countries in Asia, Southern America, and the Middle East are higher than in many Western countries. […] Our systematic review suggests that newly industrialized countries, societies that have undergone rapid economic advancement, are experiencing an upswing in the incidence of appendicitis. […] Newly industrialized countries with high and rising incidence of appendicitis need to prepare their clinical infrastructure to rapidly diagnose and manage appendicitis or otherwise risk unnecessary morbidity and mortality.

• #51 Appendicitis epidemiology and demographics – wikidoc

  https://www.wikidoc.org/index.php/Appendicitis_epidemiology_and_demographics

  Appendicitis is more common in industrialized countries in Europe and America where diets are more consistent with highly refined foods that are low in dietary fibers. […] In developing countries, the chances of appendicitis are lower because of the typical agrarian diet that is composed of more high-fiber foods as opposed to refined food.

• #52 Appendicitis: Practice Essentials, Background, Anatomy

  https://emedicine.medscape.com/article/773895-overview

  Appendicitis is one of the more common surgical emergencies, and it is one of the most common causes of abdominal pain. In the United States, 250,000 cases of appendicitis are reported annually, representing 1 million patient-days of admission. The incidence of acute appendicitis has been declining steadily since the late 1940s, and the current annual incidence is 10 cases per 100,000 population. Appendicitis occurs in 7% of the US population, with an incidence of 1.1 cases per 1000 people per year. Some familial predisposition exists. […] In Asian and African countries, the incidence of acute appendicitis is probably lower because of the dietary habits of the inhabitants of these geographic areas. The incidence of appendicitis is lower in cultures with a higher intake of dietary fiber. Dietary fiber is thought to decrease the viscosity of feces, decrease bowel transit time, and discourage formation of fecaliths, which predispose individuals to obstructions of the appendiceal lumen.

• #53 THE EPIDEMIOLOGY OF CHILDHOOD APPENDICITIS: A CASE-CONTROL STUDY | Pediatric Research

  https://www.nature.com/articles/pr1984607

  To better understand the etiology of childhood appendicitis, a case-control study of this disease was conducted among 135 children who underwent an appendectomy between November 1980 and December 1982. […] Children having one or more first degree relatives with a positive history of appendectomy for appendicitis were 1.2 times more likely to develop appendicitis (p 0.10) than children without this history. […] No significant increase in risk for appendicitis was noted in children having parents with a positive history of appendectomy for appendicitis, but children with one or more siblings affected by this disease were 9.5 time more likely to have appendicitis (p 0.05). […] As the proportion of family members with a positive history of appendectomy increased, the risk of childhood appendicitis increased (p = 0.002).

• #54 THE EPIDEMIOLOGY OF CHILDHOOD APPENDICITIS: A CASE-CONTROL STUDY | Pediatric Research

  https://www.nature.com/articles/pr1984607

  To better understand the etiology of childhood appendicitis, a case-control study of this disease was conducted among 135 children who underwent an appendectomy between November 1980 and December 1982. […] Children having one or more first degree relatives with a positive history of appendectomy for appendicitis were 1.2 times more likely to develop appendicitis (p 0.10) than children without this history. […] No significant increase in risk for appendicitis was noted in children having parents with a positive history of appendectomy for appendicitis, but children with one or more siblings affected by this disease were 9.5 time more likely to have appendicitis (p 0.05). […] As the proportion of family members with a positive history of appendectomy increased, the risk of childhood appendicitis increased (p = 0.002).

• #55 THE EPIDEMIOLOGY OF CHILDHOOD APPENDICITIS: A CASE-CONTROL STUDY | Pediatric Research

  https://www.nature.com/articles/pr1984607

  To better understand the etiology of childhood appendicitis, a case-control study of this disease was conducted among 135 children who underwent an appendectomy between November 1980 and December 1982. […] Children having one or more first degree relatives with a positive history of appendectomy for appendicitis were 1.2 times more likely to develop appendicitis (p 0.10) than children without this history. […] No significant increase in risk for appendicitis was noted in children having parents with a positive history of appendectomy for appendicitis, but children with one or more siblings affected by this disease were 9.5 time more likely to have appendicitis (p 0.05). […] As the proportion of family members with a positive history of appendectomy increased, the risk of childhood appendicitis increased (p = 0.002).

• #56

  http://liu.diva-portal.org/smash/record.jsf?pid=diva2:245878

  The study concerns appendicitis, its epidemiology and diagnosis, and the outcome of appendectomy. A population based cohort of 9,274 patients undergoing appendectomy in 1969 to 1990 in Jnkping County was retrospectively studied, and 502 patients admitted for suspected appendicitis to the hospitals in Jnkping and Eksj between October 1992 and December 1993 were prospectively studied. […] Appendicitis was found to occur in outbreaks and space-time clusters, indicating an infectious etiology. The incidence of non-perforating appendicitis was strongly age-dependent, with a peak in adolescence, whereas the incidence of perforating appendicitis was stable at all ages. This suggests that perforating and non-perforating appendicitis are separate entities. […] An analysis of population based studies showed a strong relation between surgeons’ attitude to exploration and the incidence of non-perforating appendicitis, whereas the incidence of perforating appendicitis was unrelated. This is consistent with a high proportion of potentially resolving appendicitis.

• #57

  https://www.cdc.gov/mmwr/preview/mmwrhtml/00019126.htm

  Although appendectomy for acute appendicitis is the most commonly performed emergency abdominal surgery in the United States, epidemiologic investigations to determine risk factors for and causes of this condition are limited. […] In April 1984, the Texas Department of Health learned of an apparent cluster of appendicitis cases in a town of 8,000 inhabitants. […] Eleven of the 13 patients with appendicitis (85%) were males; in 1983, three of seven patients (43%) were males. […] The cluster of appendicitis occurred 2 to 3 weeks after the majority of illnesses in the schools. […] The cluster reported here supports the hypothesis that environmental factors may contribute to appendicitis. […] Clusters of appendicitis offer a unique opportunity to identify possible risk factors and to search for precipitating infectious agents.

• #58 Pediatric Appendicitis: Practice Essentials, Anatomy, Pathophysiology

  https://emedicine.medscape.com/article/926795-overview

  Appendicitis has an incidence of 70,000 pediatric cases per year in the United States. The incidence between birth and age 4 years is 1-2 cases per 10,000 children per year. The incidence increases to 25 cases per 10,000 children per year between 10 and 17 years of age. Overall, 7% of people in the United States have their appendix removed during their lifetime. The male-to-female ratio is approximately 2:1. […] Appendicitis is much more common in developed countries. Although the reason for this discrepancy is unknown, potential risk factors include a diet low in fiber and high in sugar, family history, and infection. Gut flora and exposure to gastrointestinal infections have also been proposed as a hygiene theory of appendicitis. There may also be a role of the genetics of the host and the microbiome of the gut in the development of appendicitis and, possibly, with the risk of perforated appendicitis.

• #59 Bacterial peritonitis in paediatric appendicitis; microbial epidemiology and antimicrobial management | Annals of Clinical Microbiology and Antimicrobials | Full Text

  https://ann-clinmicrob.biomedcentral.com/articles/10.1186/s12941-023-00591-1

  Appendicitis remains a common surgical emergency in children. Empirical antibacterial treatment is indicated to reduce infective complications. We investigate the bacterial pathogens identified intra-operatively during appendectomies in children to guide empirical surgical antimicrobial prophylaxis options. […] A high proportion of children with appendicitis have Pseudomonas spp. isolated, leading to a prolonged LOS. Evolving Enterobacterales resistance and the presence of Pseudomonas spp. necessitate extended antibacterial coverage for paediatric appendectomies with evidence of peritonitis. […] The estimated lifetime risk is around 12% and 25% for males and females, respectively. Appendicitis can occur at any age; with the peak incidence occurring between the ages of 10-19 years old. […] Bacterial overgrowth is present in acute appendicitis; the most common bacterial isolates consist of Escherichia coli, Bacteroides fragilis, milleri Streptococcus spp., Peptostreptococcus spp., and Pseudomonas spp. in their order of prevalence.

• #60 Bacterial peritonitis in paediatric appendicitis; microbial epidemiology and antimicrobial management | Annals of Clinical Microbiology and Antimicrobials | Full Text

  https://ann-clinmicrob.biomedcentral.com/articles/10.1186/s12941-023-00591-1

  The presence of a cultured pathogen may not accurately reflect the problem pathogen at time of appendectomy which limits this and other similar studies. […] This study confirms that E. coli is the most commonly isolated pathogen from intra-operative cultures (42.0%), similar to other epidemiological studies. As a common commensal organism within the intestinal lumen and known invasive pathogen, it is plausible that E. coli is responsible for postoperative infective complications and warrants empiric antibacterial coverage. […] The clinical significance of intra-operative Pseudomonas spp. is not fully understood. Unlike in adult appendicitis, paediatric cases persistently report on the presence of Pseudomonas spp. with prevalence ranging from 0 to 29% of all cultures, similar to the rate found in this local study (21%).

• #61 The global, regional, and national burden of appendicitis in 204 countries and territories, 1990–2019: a systematic analysis from the Global Burden of Disease Study 2019 | BMC Gastroenterology | Full Text

  https://bmcgastroenterol.biomedcentral.com/articles/10.1186/s12876-023-02678-7

  Appendicitis is the most common abdominal surgical emergency worldwide, and its burden has been changing. We report the level and trends of appendicitis prevalence, and incidence; and years lived with disability (YLD) in 204 countries and territories from 1990 to 2019, based on data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019. […] The numbers and age-standardized prevalence, incidence, and YLD rates per 100,000 population of appendicitis were estimated across regions and countries by age, sex, and sociodemographic index (SDI). All the estimates were reported with 95% uncertainty intervals (UIs). […] Globally, the age-standardized prevalence and incidence rates of appendicitis in 2019 were 8.7 (95% UI 6.9 to 11.0) and 229.9 (95% UI 180.9 to 291.0) per 100,000 population, with increases of 20.8% (95% UI 18.9 to 23.0%) and 20.5% (95% UI 18.7 to 22.8%) from 1990 to 2019, respectively. Additionally, the age-standardized YLDs rate was 2.7 (95% UI 1.8 to 3.9) in 2019, with an increase of 20.4% (95% UI 16.2 to 25.1%) from 1990 to 2019.

• #62 The global, regional, and national burden of appendicitis in 204 countries and territories, 1990–2019: a systematic analysis from the Global Burden of Disease Study 2019 | BMC Gastroenterology | Full Text

  https://bmcgastroenterol.biomedcentral.com/articles/10.1186/s12876-023-02678-7

  Appendicitis is the most common abdominal surgical emergency worldwide, and its burden has been changing. We report the level and trends of appendicitis prevalence, and incidence; and years lived with disability (YLD) in 204 countries and territories from 1990 to 2019, based on data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019. […] The numbers and age-standardized prevalence, incidence, and YLD rates per 100,000 population of appendicitis were estimated across regions and countries by age, sex, and sociodemographic index (SDI). All the estimates were reported with 95% uncertainty intervals (UIs). […] Globally, the age-standardized prevalence and incidence rates of appendicitis in 2019 were 8.7 (95% UI 6.9 to 11.0) and 229.9 (95% UI 180.9 to 291.0) per 100,000 population, with increases of 20.8% (95% UI 18.9 to 23.0%) and 20.5% (95% UI 18.7 to 22.8%) from 1990 to 2019, respectively. Additionally, the age-standardized YLDs rate was 2.7 (95% UI 1.8 to 3.9) in 2019, with an increase of 20.4% (95% UI 16.2 to 25.1%) from 1990 to 2019.

• #63 Global burden of appendicitis in 204 countries & territories | CLEP

  https://www.dovepress.com/the-global-burden-of-appendicitis-in-204-countries-and-territories-fro-peer-reviewed-fulltext-article-CLEP

  Appendicitis is a common surgical emergency. This study aimed to estimate the worldwide burden and trends of appendicitis from 1990 to 2019. Global incidence grew by 63.55% between 1990 and 2019, age-standardized incidence rate climbed by an estimated percentage change of 0.58 per year, whereas the number of DALY declined by 31.93% during the same period, with an estimated annual percentage change of 2.77. In 2019, the areas of Andean Latin America and the Caribbean had the highest age-standardized rates of incidence and DALYs. While South Asia saw the largest increase in age-standardized incidence rates, Andean Latin America saw the biggest decline in age-standardized rates of incidence and DALYs. Significant negative correlations between age-standardized DALY rates and socio-demographic index, between estimated annual percentage change and age-standardized incidence rates, were observed at the national level.

• #64 Global burden of appendicitis in 204 countries & territories | CLEP

  https://www.dovepress.com/the-global-burden-of-appendicitis-in-204-countries-and-territories-fro-peer-reviewed-fulltext-article-CLEP

  This study analyzed the substantial burden of appendicitis worldwide over the past three decades. We reported the overall and age-standardized appendicitis incidence and DALY burden at the global, regional, and national levels from 1990 to 2019. Although DALYs decreased over the study period, the burden of incidence increased.

• #65 Global burden of appendicitis in 204 countries & territories | CLEP

  https://www.dovepress.com/the-global-burden-of-appendicitis-in-204-countries-and-territories-fro-peer-reviewed-fulltext-article-CLEP

  In this study, using the data from the Global Burden of Diseases, Injuries, and Risk Factors Study 2019 (GBD 2019), we analyzed the appendicitis burden of incidence and DALYs at the global, regional, and national levels stratified by sex, age, and SDI and in terms of numbers and age-standardized rates (ASRs) from 1990 to 2019. […] In 2019, there were 17.70 million new cases of appendicitis globally, with an age-standardized incidence rate (ASIR) of 229.86 per 100,000 population. The incidence increased by 63.55% and ASIRs increased with an EAPC of 0.58 from 1990 to 2019. Globally, there were 1.50 million DALYs attributed to appendicitis in 2019, representing a decrease of 31.93% from 1990 to 2019. […] The highest ASIR was observed in the low-middle SDI quintiles among all SDI regions, whereas the lowest ASIR was observed in the low SDI quintiles. From 1990 to 2019, the number of incident cases increased across all SDI quintiles.

• #66 Global burden of appendicitis in 204 countries & territories | CLEP

  https://www.dovepress.com/the-global-burden-of-appendicitis-in-204-countries-and-territories-fro-peer-reviewed-fulltext-article-CLEP

  The burden of incidence and DALYs were higher for women globally. The Wilcoxon test showed significant differences between sexes in the global incidence burden of numbers and rates among different age groups. […] In 2019, the highest ASIRs were observed in Andean Latin America, high-income Asia Pacific, and Central Latin America. The lowest ASIRs were observed in Oceania, Western Sub-Saharan Africa, and Eastern Sub-Saharan Africa. […] The top three countries in terms of appendicitis ASIR in 2019 were Bangladesh, Bhutan, and Peru. In contrast, Ethiopia, Kenya, and Indonesia had the lowest ASIRs in 2019. […] Overall, a slightly positive correlation was found between ASIR and SDI in global regions from 1990 to 2019, while a prominent negative correlation was observed between age-standardized DALY rates and SDI.

• #67 The global, regional, and national burden of appendicitis in 204 countries and territories, 1990–2019: a systematic analysis from the Global Burden of Disease Study 2019 | BMC Gastroenterology | Full Text

  https://bmcgastroenterol.biomedcentral.com/articles/10.1186/s12876-023-02678-7

  The present study found that the highest age-standardized rates were more common in less-developed regions, such as Andean Latin America, Central Latin America, and Central Sub-Saharan Africa. […] The differences between regions and countries may be due to differences in healthcare systems, socioeconomic statuses of the population, race, eating habits, and environmental exposures. […] The present study found that the SDI was an important factor in the appendicitis burden, and a generally positive association was observed between the regional- and national-level SDI and YLD because of appendicitis from 1990 to 2019.

• #68

  https://journals.lww.com/annalsofsurgery/fulltext/2017/08000/the_global_incidence_of_appendicitis__a_systematic.8.aspx

  Population-based incidence studies are necessary for many developing regions, as the impact of appendicitis is unknown in these areas. […] The epidemiologic patterns of appendicitis support the notion that appendicitis is driven by multifactorial environmental triggers associated with the industrialization of society.

• #69 Perforated appendix | Radiology Reference Article | Radiopaedia.org

  https://radiopaedia.org/articles/perforated-appendix?lang=us

  The rate of perforated appendix varies from 16% to 40%, with a higher incidence in a younger age group and in patients older than 50 years. […] Perforation can be due to a late and atypical presentation of appendicitis, a delay in diagnosis, a delayed decision for surgery, and age-specific physiological changes.

• #70 Appendicitis: Practice Essentials, Background, Anatomy

  https://emedicine.medscape.com/article/773895-overview

  In the last few years, a decrease in frequency of appendicitis in Western countries has been reported, which may be related to changes in dietary fiber intake. In fact, the higher incidence of appendicitis is believed to be related to poor fiber intake in such countries. […] There is a slight male preponderance of 3:2 in teenagers and young adults; in adults, the incidence of appendicitis is approximately 1.4 times greater in men than in women. The incidence of primary appendectomy is approximately equal in both sexes. […] The incidence of appendicitis gradually rises from birth, peaks in the late teen years, and gradually declines in the geriatric years. The mean age when appendicitis occurs in the pediatric population is 6-10 years. Lymphoid hyperplasia is observed more often among infants and adults and is responsible for the increased incidence of appendicitis in these age groups. Younger children have a higher rate of perforation, with reported rates of 50-85%. The median age at appendectomy is 22 years. Although rare, neonatal and even prenatal appendicitis have been reported. Clinicians must maintain a high index of suspicion in all age groups.

• #71 Acute Appendicitis: Review and Update | AAFP

  https://www.aafp.org/pubs/afp/issues/1999/1101/p2027.html

  Appendicitis is common, with a lifetime occurrence of 7 percent. […] Appendicitis is the most common acute surgical condition of the abdomen. Approximately 7 percent of the population will have appendicitis in their lifetime, with the peak incidence occurring between the ages of 10 and 30 years. […] The mortality rate in nonperforated appendicitis is less than 1 percent, but it may be as high as 5 percent or more in young and elderly patients, in whom diagnosis may often be delayed, thus making perforation more likely. […] Factors that increase the rate of perforation are delayed presentation to medical care, age extremes (young and old) and hidden location of appendix. […] Young children are unable to relate a history, often have abdominal pain from other causes and may have more nonspecific signs and symptoms. These factors contribute to a perforation rate as high as 50 percent in this group.

• #72 Perforated appendix | Radiology Reference Article | Radiopaedia.org

  https://radiopaedia.org/articles/perforated-appendix?lang=us

  The rate of perforated appendix varies from 16% to 40%, with a higher incidence in a younger age group and in patients older than 50 years. […] Perforation can be due to a late and atypical presentation of appendicitis, a delay in diagnosis, a delayed decision for surgery, and age-specific physiological changes.

• #73 Acute Appendicitis: Review and Update | AAFP

  https://www.aafp.org/pubs/afp/issues/1999/1101/p2027.html

  In pregnancy, the location of the appendix begins to shift significantly by the fourth to fifth months of gestation. […] Elderly patients have the highest mortality rates. The usual signs and symptoms of appendicitis may be diminished, atypical or absent in the elderly, which leads to a higher rate of perforation. More frequent perforation combined with a higher incidence of other medical problems and less reserve to fight infection contribute to a mortality rate of up to 5 percent or more.

• #74

  https://he01.tci-thaijo.org/index.php/PSUMJ/article/view/264804

  The overall mortality was 2.3%. […] A significantly higher mortality rate was found in cases with extreme age (pediatric or geriatric), those with co-morbidities (diabetes, hypertension, dyslipidemia, chronic pulmonary disease, chronic kidney disease), and those with complications, especially generalized peritonitis, sepsis, and acute kidney injury. […] A decision-tree prediction model suggested that sepsis and renal complication were key nodes determining mortality risk in pediatric and geriatric appendicitis. […] A mortality risk from appendicitis remains in Thai patients, especially the elderly with co-morbidities and those with generalized peritonitis, sepsis, or renal complications. Early diagnosis and improvement in perioperative care in the extreme age groups might improve the mortality figure.

• #75 Analyzing the dynamics of complicated and uncomplicated appendicitis during the COVID-19 pandemic in Seoul, Korea: a multifaceted time series approach

  https://www.e-epih.org/journal/view.php?number=1547

  This study investigated the impact of the coronavirus disease 2019 (COVID-19) pandemic and associated control strategies on the incidence of appendicitis in Seoul, using data from 2018 to 2020 from Korea’s National Health Insurance. […] The spline regression analysis indicated decreasing trends in both total and uncomplicated appendicitis cases. Conversely, the incidence of complicated appendicitis and the ratio of complicated to uncomplicated cases increased. […] The COVID-19 pandemic resulted in a decrease in both total and uncomplicated appendicitis cases, while the number of complicated cases increased. […] Several studies have reported changes in the epidemiology of acute appendicitis during the COVID-19 pandemic; this study aimed to confirm these findings using national health insurance claims data.

• #76 Analyzing the dynamics of complicated and uncomplicated appendicitis during the COVID-19 pandemic in Seoul, Korea: a multifaceted time series approach

  https://www.e-epih.org/journal/view.php?doi=10.4178/epih.e2024081

  This study investigated the impact of the coronavirus disease 2019 (COVID-19) pandemic and associated control strategies on the incidence of appendicitis in Seoul, using data from 2018 to 2020 from Korea’s National Health Insurance. […] The spline regression analysis indicated decreasing trends in both total and uncomplicated appendicitis cases. Conversely, the incidence of complicated appendicitis and the ratio of complicated to uncomplicated cases increased. […] The COVID-19 pandemic resulted in a decrease in both total and uncomplicated appendicitis cases, while the number of complicated cases increased. […] Several studies have reported changes in the epidemiology of acute appendicitis during the COVID-19 pandemic; this study aimed to confirm these findings using national health insurance claims data.

• #77 Analyzing the dynamics of complicated and uncomplicated appendicitis during the COVID-19 pandemic in Seoul, Korea: a multifaceted time series approach

  https://www.e-epih.org/journal/view.php?number=1547

  The results reveal that while the incidence of uncomplicated appendicitis has decreased, the incidence of complicated appendicitis has increased. […] During the COVID-19 pandemic, the incidence rates of total acute appendicitis and uncomplicated appendicitis significantly decreased in Seoul, while the incidence of complicated appendicitis significantly increased. […] The epidemiological changes in appendicitis are likely influenced by shifts in healthcare utilization patterns and alterations in the capacity of medical facilities. […] The increased burden on the healthcare system, coupled with patients’ avoidance of hospital visits due to the COVID-19 pandemic, may have delayed the timely diagnosis and treatment of appendicitis. […] Systematic reviews and meta-analyses have reported an increase in the incidence of complicated appendicitis, associated with delays in surgery during the pandemic. […] The observed increase in the incidence of complicated appendicitis, coupled with a decrease in uncomplicated cases, can be attributed to a combination of these factors.

• #78 Analyzing the dynamics of complicated and uncomplicated appendicitis during the COVID-19 pandemic in Seoul, Korea: a multifaceted time series approach

  https://www.e-epih.org/journal/view.php?doi=10.4178/epih.e2024081

  The results reveal that while the incidence of uncomplicated appendicitis has decreased, the incidence of complicated appendicitis has increased. […] During the COVID-19 pandemic, the incidence rates of total acute appendicitis and uncomplicated appendicitis significantly decreased in Seoul, while the incidence of complicated appendicitis significantly increased. […] The epidemiological changes in appendicitis are likely influenced by shifts in healthcare utilization patterns and alterations in the capacity of medical facilities. […] Systematic reviews and meta-analyses have reported an increase in the incidence of complicated appendicitis, associated with delays in surgery during the pandemic. […] The observed increase in the incidence of complicated appendicitis, coupled with a decrease in uncomplicated cases, can be attributed to a combination of these factors.

• #79 Epidemiology and Outcome of Acute Appendicitis during and before the COVID-19 Pandemic: A Retrospective Single-Center Analysis

  https://www.mdpi.com/1648-9144/59/5/902

  Epidemiology and Outcome of Acute Appendicitis during and before the COVID-19 Pandemic: A Retrospective Single-Center Analysis […] Background and Objectives: We investigated epidemiological factors and outcomes, including the development of complications, for patients with appendicitis according to three sequential coronavirus disease 2019 (COVID-19) pandemic periods, divided by specific time points. […] Acute appendicitis is one of the common causes of acute abdomen and is the most common indicator for emergency abdominal surgery. Previous studies have reported that during the pandemic, a significant increase in complications and length of stay for acute appendicitis was noted, compared with that from before the COVID-19 pandemic. […] This study found no differences in postoperative complications or treatment durations between pandemic periods. The incidence of appendicitis complications was significantly influenced by age and the duration between the onset of symptoms and arrival at the emergency department, but not by the pandemic period itself. […] The incidence of complications was not affected during the pandemic period (before the pandemic, 58.0%; period A, 62.7%; period B, 55.4%; and period C, 58.1%; p = 0.358). […] The time from symptom onset to emergency department (ED) arrival significantly decreased during the pandemic (before the pandemic 47.8 ± 84.3 h; pandemic 35.0 ± 54 h; p = 0.003). […] The time from ED visit to the operating room was statistically significantly increased during the pandemic (before the pandemic 14.3 ± 21.67 h; period A 18.8 ± 14.02 h; period B 18.8 ± 8.57 h; period C 18.3 ± 12.95 h; p = 0.001). […]

• #80 Global burden of appendicitis in 204 countries & territories | CLEP

  https://www.dovepress.com/the-global-burden-of-appendicitis-in-204-countries-and-territories-fro-peer-reviewed-fulltext-article-CLEP

  This study analyzed the substantial burden of appendicitis worldwide over the past three decades. We reported the overall and age-standardized appendicitis incidence and DALY burden at the global, regional, and national levels from 1990 to 2019. Although DALYs decreased over the study period, the burden of incidence increased.

• #81 Global burden of appendicitis in 204 countries & territories | CLEP

  https://www.dovepress.com/the-global-burden-of-appendicitis-in-204-countries-and-territories-fro-peer-reviewed-fulltext-article-CLEP

  Appendicitis remains a major global health concern. Although the trends in DALYs decreased, the burden of incidence increased from 1990 to 2019. Policymakers should create health policies adapted to local conditions to manage the burden of appendicitis globally. […] Appendicitis is one of the most common surgical emergencies globally and imposes an important burden on modern health systems. Because it is very common among adults and children worldwide, previous studies of appendicitis epidemics have mainly focused on incident cases. Although the pooled incidence of the disease has been decreasing in high-income regions and countries since the 1990s, it has increased in newly industrialized countries. […] The Global Burden of Disease (GBD) study has estimated a variety of metrics for diseases annually since 1990 and provides a great opportunity for comparable assessments of disease burden and trends at the global, regional, and national levels; however, no study addressing these data on appendicitis has been published.

• #82

  https://journals.lww.com/annalsofsurgery/fulltext/2017/08000/the_global_incidence_of_appendicitis__a_systematic.8.aspx

  In Western countries, appendicitis has mostly stabilized during the latter portion of the 20th century. In Northern America the incidence is 100 per 100,000 person-years with nearly 400,000 diagnoses in 2015. In contrast, incidence is increasing in newly industrialized countries of Asia, the Middle East, Southern America, and Africa. […] Since 2000, the incidences of appendicitis in countries in Asia, Southern America, and the Middle East are higher than in many Western countries. […] Our systematic review suggests that newly industrialized countries, societies that have undergone rapid economic advancement, are experiencing an upswing in the incidence of appendicitis. […] Newly industrialized countries with high and rising incidence of appendicitis need to prepare their clinical infrastructure to rapidly diagnose and manage appendicitis or otherwise risk unnecessary morbidity and mortality.

• #83 The global, regional, and national burden of appendicitis in 204 countries and territories, 1990–2019: a systematic analysis from the Global Burden of Disease Study 2019 | BMC Gastroenterology | Full Text

  https://bmcgastroenterol.biomedcentral.com/articles/10.1186/s12876-023-02678-7

  Appendicitis remains a major public health challenge globally. Increasing awareness of appendicitis and its risk factors and the importance of early diagnosis and treatment is warranted to reduce its the burden. […] The incidence of appendicitis is approximately 233 per 100,000 population per year, with a lifetime incidence risk ranging from 6.7 to 8.6%. […] Although Western countries have reported a decrease in its incidence in the mid-twentieth century, newly industrialized countries have shown an increasing trend in the twenty-first century. […] The latest study reported the global incidence and mortality from appendicitis using data from the (Global Burden of Disease Study) [GBD], but the 21 GBD regions and 204 countries were not analyzed in this study; in addition, prevalence and YLDs were unavailable from this study.

• #84

  https://journals.lww.com/annalsofsurgery/fulltext/2017/08000/the_global_incidence_of_appendicitis__a_systematic.8.aspx

  Population-based incidence studies are necessary for many developing regions, as the impact of appendicitis is unknown in these areas. […] The epidemiologic patterns of appendicitis support the notion that appendicitis is driven by multifactorial environmental triggers associated with the industrialization of society.

• #85

  https://www.cdc.gov/mmwr/preview/mmwrhtml/00019126.htm

  Although appendectomy for acute appendicitis is the most commonly performed emergency abdominal surgery in the United States, epidemiologic investigations to determine risk factors for and causes of this condition are limited. […] In April 1984, the Texas Department of Health learned of an apparent cluster of appendicitis cases in a town of 8,000 inhabitants. […] Eleven of the 13 patients with appendicitis (85%) were males; in 1983, three of seven patients (43%) were males. […] The cluster of appendicitis occurred 2 to 3 weeks after the majority of illnesses in the schools. […] The cluster reported here supports the hypothesis that environmental factors may contribute to appendicitis. […] Clusters of appendicitis offer a unique opportunity to identify possible risk factors and to search for precipitating infectious agents.

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