Zbierska Katarzyna, Kenig Jakub, Lasek Anna, Rubinkiewicz Mateusz, Wałęga Piotr
Pol Przegl Chir. 2016 May 1;88(3):142-6. doi: 10.1515/pjs-2016-0042.
Acute appendicitis (AA) still remains the most common acute surgical abdominal emergency. Although 90% of cases occur in children and young adults, the incidence in the elderly amounts up to 10% and is constantly rising. The aim of the study was to assess the differences between clinical presentation in the elderly patients with AA compared to the younger patients. Additional aim was to assess the correlation between in-hospital time delays and patients' outcomes.
We conducted a retrospective analysis of medical data of 274 patients admitted to 3rd Department of General Surgery in Cracow between January 2011 and December 2013 due to AA. The elderly group comprised 23 patients aged 65 and above and the non-elderly group consisted of 251 patients.
The groups did not differ in symptoms and their duration, type of surgery and its duration. However, time from admission to ED to the beginning of the procedure was significantly lower in the elderly group (575.56 vs 858.9 min; p=0.03). The elderly had longer hospital stay (6.08 vs 4.69 days; p=0.004). In the elderly group the perforation rate was close to reaching statistical significance (26.1% vs 12.4%; p=0.06). No mortality was noted in both groups and morbidity was slightly higher in elderly group (17.4% vs 10%; p=0.26).
There was no difference in the clinical presentation between elderly and non-elderly patients group. However, elderly patients presented with a more progressed inflammation of the appendix. The hospital stay was longer in the elderly group, without any mortality and with higher rate of morbidity in this group. The length of the preoperative phase was significantly shorter, confirming the awareness of importance of time in the elderly patients with acute abdomen.
急性阑尾炎（AA）仍然是最常见的急性外科腹部急症。尽管90%的病例发生在儿童和年轻人中，但老年人中的发病率高达10%，且呈持续上升趋势。本研究的目的是评估老年急性阑尾炎患者与年轻患者临床表现的差异。另一个目的是评估住院时间延迟与患者预后之间的相关性。
我们对2011年1月至2013年12月因急性阑尾炎入住克拉科夫第三普通外科的274例患者的医疗数据进行了回顾性分析。老年组包括23例65岁及以上的患者，非老年组由251例患者组成。
两组在症状及其持续时间、手术类型及其持续时间方面没有差异。然而，老年组从入院到急诊科到手术开始的时间明显更短（575.56分钟对858.9分钟；p = 0.03）。老年人的住院时间更长（6.08天对4.69天；p = 0.004）。老年组的穿孔率接近具有统计学意义（26.1%对12.4%；p = 0.06）。两组均未观察到死亡病例，老年组的发病率略高（17.4%对10%；p = 0.26）。
老年患者组和非老年患者组的临床表现没有差异。然而，老年患者的阑尾炎症进展更明显。老年组的住院时间更长，无死亡病例，但该组发病率更高。术前阶段的时间明显更短，这证实了老年急腹症患者对时间重要性的认识。
