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World Journal of Surgery

, Volume 36, Issue 12, pp 2787–2794 | Cite as

Examining a Common Disease with Unknown Etiology: Trends in Epidemiology and Surgical Management of Appendicitis in California, 1995–2009

  • Jamie E. AndersonEmail author
  • Stephen W. Bickler
  • David C. Chang
  • Mark A. Talamini
Article

Abstract

Background

The study was designed to examine the epidemiology of appendicitis and risk factors of perforation and appendectomy.

Methods

Retrospective analysis of the California Office of Statewide Health Planning and Development Patient Discharge Data was performed from 1995 to 2009. Patients with appendicitis were identified by ICD-9 diagnosis code. Population statistics from the RAND Corporation were used to calculate incidence rates. Risk factors of perforation and appendectomy were also calculated.

Results

A total of 608,116 patients with appendicitis (70 % non-perforated) were included. The incidence increased at an average rate of 0.5 cases/100,000 population/year (p < 0.001), with annual incidence peaking during the third quarter. Children age 10–14 had the highest rates of appendicitis (169.6 cases/100,000). The lifetime cumulative incidence rate is 9.0 %. Appendicitis is most common in whites and Hispanics and less common in African Americans and Asians. Risks of perforation include Hispanic or Asian race, young or old age, and non-private insurance. The adjusted odds of appendectomy increased since 1995 in patients with non-perforated appendicitis (OR 1.5, 95 % CI (1.3–1.7); p < 0.001), but it decreased in patients with perforated appendicitis (OR 0.4, 95 % CI (0.4–0.5); p < 0.001).

Conclusions

This is the largest epidemiological study of appendicitis to our knowledge in recent years. Incidence has increased over time and is higher in the summer months. Whites and Hispanics have higher rates of appendicitis, but Hispanics and Asians and patients with non-private insurance, have higher odds of perforation. Surgical management of perforated appendicitis has decreased over time. It is unknown why the incidence has increased, displays seasonality, and varies by race.

Keywords

Appendicitis Private Insurance Acute Care Hospital Perforated Appendicitis Perforation Rate 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Notes

Conflict of interest

The authors declare no conflict of interest or financial ties to disclose.

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Copyright information

© Société Internationale de Chirurgie 2012

Authors and Affiliations

  • Jamie E. Anderson
    • 1
    Email author
  • Stephen W. Bickler
    • 1
  • David C. Chang
    • 1
  • Mark A. Talamini
    • 1
  1. 1.Department of Surgery, Center for Surgical Systems and Public HealthUniversity of California San DiegoSan DiegoUSA

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