Lin Kai-Biao, Lai K Robert, Yang Nan-Ping, Chan Chien-Lung, Liu Yuan-Hung, Pan Ren-Hao, Huang Chien-Hsun
School of Computer & Information Engineering, Xiamen University of Technology, Xiamen, 361024 China.
Department of Computer Science and Engineering, Yuan Ze University, Taoyuan, 32003 Taiwan.
World J Emerg Surg. 2015 Sep 17;10:42. doi: 10.1186/s13017-015-0036-3. eCollection 2015.
This paper presents an epidemiologic study of appendicitis in Taiwan over a twelve-year period. An analysis of the incidence in the low-income population (LIP) is included to explore the effects of lower socioeconomic status on appendicitis.
We analyzed the epidemiological features of appendicitis in Taiwan using data from the National Health Insurance Research Database (NHIRD) from 2000 to 2011. All cases diagnosed as appendicitis were enrolled.
The overall incidences of appendicitis, primary appendectomy, and perforated appendicitis were 107.76, 101.58, and 27.20 per 100,000 per year, respectively. The highest incidence of appendicitis was found in persons aged 15 to 29 years; males had higher rates of appendicitis than females at all ages except for 70 years and older. Appendicitis rates were 11.76 % higher in the summer than in the winter months. A multilevel analysis with hierarchical linear modeling (HLM) revealed that male patients, younger patients (aged ≤14 years), and elderly patients (aged ≥60 years) had a higher risk of perforated appendicitis; among adults, the incidence increased with age. Moreover, the risk of perforation was higher in patients with one or more comorbidities. LIP patients comprised 1.25 % of the total number of patients with appendicitis from 2000 to 2011. The overall incidence of appendicitis was 34.99 % higher in the LIP than in the normal population (NP), and the incidence of perforated appendicitis was 40.40 % higher in the LIP than in the NP. After multivariate adjustment, the adjusted hospital costs and length of hospital stay (LOS) for the LIP patients were higher than those for the NP patients.
Appendicitis and appendectomy in Taiwan had similar overall incidences, seasonality patterns, and declining trends compared to numerous previous studies. Compared to NP patients, LIP patients had a higher risk of appendicitis, longer LOS and higher hospital costs as a result of appendectomy.
本文呈现了一项对台湾地区12年间阑尾炎的流行病学研究。其中纳入了对低收入人群（LIP）发病率的分析，以探究社会经济地位较低对阑尾炎的影响。
我们利用2000年至2011年国民健康保险研究数据库（NHIRD）的数据，分析了台湾地区阑尾炎的流行病学特征。所有诊断为阑尾炎的病例均被纳入研究。
阑尾炎、原发性阑尾切除术和穿孔性阑尾炎的年总发病率分别为每10万人107.76例、101.58例和27.20例。阑尾炎发病率最高的是15至29岁的人群；除70岁及以上年龄段外，各年龄段男性的阑尾炎发病率均高于女性。夏季的阑尾炎发病率比冬季高11.76%。采用分层线性模型（HLM）进行的多层次分析显示，男性患者、年轻患者（年龄≤14岁）和老年患者（年龄≥60岁）发生穿孔性阑尾炎的风险更高；在成年人中，发病率随年龄增长而增加。此外，患有一种或多种合并症的患者发生穿孔的风险更高。2000年至2011年，LIP患者占阑尾炎患者总数的1.25%。LIP人群中阑尾炎的总体发病率比正常人群（NP）高34.99%，穿孔性阑尾炎的发病率比NP人群高40.40%。多变量调整后，LIP患者的调整后住院费用和住院时间（LOS）均高于NP患者。
与以往众多研究相比，台湾地区的阑尾炎和阑尾切除术在总体发病率、季节性模式和下降趋势方面相似。与NP患者相比，LIP患者患阑尾炎的风险更高，阑尾切除术后住院时间更长，住院费用更高。
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