Lau W Y, Fan S T, Yiu T F, Chu K W, Lee J M
Surg Gynecol Obstet. 1985 Aug;161(2):157-60.
A prospective study was done on 104 patients more than 60 years old with appendicitis. The clinical features are by and large, similar to that of the younger patient. However, four patients presented atypically with abdominal distension with little or no pain. A statistically significant increase in appendiceal perforation is found in patients more than 70 years old and in patients with prolonged delay in operation. However, delay on the part of the surgeon contributed only slightly to the high appendiceal perforation as 85.6 per cent of patients who were operated upon within 24 hours of admission. Appendicitis in the elderly patient appeared to progress to perforation faster and perforation occurred in about 40 per cent of patients within 24 hours of onset of symptoms. Five patients died and 29 postoperative complications occurred in 24 more patients. An associated medical disease is linked to a statistically significant increase in mortality. Appendiceal perforation and a total delay of more than 37 hours are associated with a statistically significant increase in morbidity.
对104例60岁以上的阑尾炎患者进行了一项前瞻性研究。其临床特征总体上与年轻患者相似。然而，有4例患者表现不典型，出现腹胀，疼痛轻微或无疼痛。研究发现，70岁以上患者以及手术延迟时间较长的患者阑尾穿孔发生率有统计学意义的增加。然而，外科医生的延迟对高阑尾穿孔率的影响较小，因为85.6%的患者在入院后24小时内接受了手术。老年患者的阑尾炎似乎进展为穿孔更快，约40%的患者在症状出现后24小时内发生穿孔。5例患者死亡，另有24例患者出现29例术后并发症。相关内科疾病与死亡率有统计学意义的增加相关。阑尾穿孔和总延迟超过37小时与发病率有统计学意义的增加相关。
