Kang J Y, Hoare J, Majeed A, Williamson R C N, Maxwell J D
Department of Gastroenterology, St George's Hospital, University College London, London, UK.
Br J Surg. 2003 Dec;90(12):1586-92. doi: 10.1002/bjs.4363.
The incidence of acute appendicitis declined in western countries between the 1930s and the early 1990s. The aim of this study was to determine time trends in hospital admissions for acute appendicitis in England between 1989-1990 and 1999-2000, and in population mortality rates for appendicitis from 1979 to 1999.
: Hospital Episode Statistics for admissions were obtained from the Department of Health and mortality data from the Office for National Statistics.
Between 1989-1990 and 1999-2000, age-standardized hospital admission rates for acute appendicitis decreased by 12.5 per cent in male patients and by 18.8 per cent in female patients. The proportions of admissions that resulted in operation remained stable. Admission rates for non-specific mesenteric lymphadenitis fell. Admission rates for abdominal pain increased between 1989-1990 and 1995-1996, at which time the International Classification of Diseases codes changed. Between 1995-1996 and 1999-2000, admission rates for abdominal pain declined. Analysis of age-specific admission rates for acute appendicitis and abdominal pain from 1989-1990 to 1995-1996 showed that the decline in acute appendicitis could not be accounted for by a change in diagnostic practice. Mortality rates for acute appendicitis remained stable over the study period.
Admission rates for acute appendicitis declined over the study period. This decline cannot be explained by reclassification.
20世纪30年代至90年代初，西方国家急性阑尾炎的发病率有所下降。本研究的目的是确定1989 - 1990年至1999 - 2000年期间英格兰急性阑尾炎住院率的时间趋势，以及1979年至1999年期间阑尾炎的人群死亡率。
从卫生部获取住院病例统计数据，从国家统计局获取死亡率数据。
在1989 - 1990年至1999 - 2000年期间，急性阑尾炎的年龄标准化住院率男性患者下降了12.5%，女性患者下降了18.8%。导致手术的住院比例保持稳定。非特异性肠系膜淋巴结炎的住院率下降。1989 - 1990年至1995 - 1996年期间腹痛的住院率上升，此时国际疾病分类代码发生了变化。在1995 - 1996年至1999 - 2000年期间，腹痛的住院率下降。对1989 - 1990年至1995 - 1996年期间急性阑尾炎和腹痛的年龄特异性住院率分析表明，急性阑尾炎的下降不能用诊断实践的变化来解释。在研究期间，急性阑尾炎的死亡率保持稳定。
在研究期间，急性阑尾炎的住院率下降。这种下降无法用重新分类来解释。
