Almström M, Svensson J F, Svenningsson A, Hagel E, Wester T
Department of Paediatric Surgery, Astrid Lindgren Children's Hospital Karolinska University Hospital Stockholm Sweden.
Department of Women's and Children's Health Karolinska Institutet Stockholm Sweden.
BJS Open. 2018 Apr 19;2(3):142-150. doi: 10.1002/bjs5.52. eCollection 2018 Jun.
The long-term incidence of acute appendicitis has been reported to be declining in Europe and North America. Recent reports, however, indicate stabilized or even increased rates. The aim of this study was to investigate the present epidemiology of acute appendicitis and appendicectomy in a population-based cohort of Swedish children.
The Swedish National Patient Register was queried for all children with acute appendicitis and/or appendicectomy in 1987-2013. Population-based incidence rates were calculated. Rates were age- and sex-adjusted, and analysed for temporal and regional trends.
Some 56 774 children with acute appendicitis were identified, of whom 53 478 (94·2 per cent) underwent appendicectomy. The incidence rate of acute appendicitis declined by 43·7 per cent over 26 years, from 177·7 to 100·1 per 100 000 person-years between 1987 and 2013. The most significant reduction was for non-perforated appendicitis, from 138·5 to 68·4 per 100 000 person-years between 1987 and 2009. The incidence rate of perforated appendicitis decreased from 28·0 to 19·9 per 100 000 person-years and negative appendicectomies reduced from 48·5 to 3·6 per 100 000 person-years during the study interval.
The incidence rates of acute appendicitis and negative appendicectomy have reduced markedly in Swedish children over time, with significantly different trends amongst non-perforated appendicitis and perforated appendicitis. The full explanation for the observed findings is unclear.
据报道，欧洲和北美的急性阑尾炎长期发病率呈下降趋势。然而，最近的报告表明发病率趋于稳定甚至有所上升。本研究的目的是调查瑞典儿童基于人群队列的急性阑尾炎和阑尾切除术的当前流行病学情况。
查询瑞典国家患者登记处1987 - 2013年间所有患有急性阑尾炎和/或接受阑尾切除术的儿童。计算基于人群的发病率。发病率进行了年龄和性别调整，并分析了时间和区域趋势。
共识别出约56774例急性阑尾炎患儿，其中53478例（94.2%）接受了阑尾切除术。1987年至2013年的26年间，急性阑尾炎发病率下降了43.7%，从每10万人年177.7例降至100.1例。最显著的下降是在非穿孔性阑尾炎方面，1987年至2009年间从每10万人年138.5例降至68.4例。在研究期间，穿孔性阑尾炎的发病率从每10万人年28.0例降至19.9例，阴性阑尾切除术从每10万人年48.5例降至3.6例。
随着时间的推移，瑞典儿童急性阑尾炎和阴性阑尾切除术的发病率显著降低，非穿孔性阑尾炎和穿孔性阑尾炎的趋势存在显著差异。对观察结果的完整解释尚不清楚。
