THE CONTINUING CHALLENGE OF PERFORATING APPENDICITIS

  • 1 January 1980
    • journal article
    • research article
    • Vol. 150  (4) , 535-538
Abstract
A series of 335 consecutive patients treated for acute appendicitis is presented. The incidence of perforation in the series was 32.2%. The mortality was 0.3% for the total series and 0.9% for those patients with perforating appendicitis. When perforation occurs, a 2-fold increase in the hospital stay and a 3-fold increase in hospital costs result. A complication rate of 47.2% in instances of perforation was significantly greater than that noted in instances of nonperforation. A 40% incidence of perforation was noted during the 1st decade of life, after which the frequency of perforation declines. Beginning with the 5th decade, a progressive increase in the incidence of perforation was noted. Prior to hospital admission, a significant delay was noted among patients with perforation. Those with perforating appendicitis were far more likely to have been seen previously by a physician who failed to advise hospital admission. A significant in-hospital delay, from admission to operation, was noted in patients with perforating appendicitis. While geographic access to health care did influence the incidence of perforation, insurance status and possession of a telephone did not.

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