Nabi Rayyan, Rath Shree, Ahmad Chaudhry Sohaib Aftab, Rajpar Najaf Ahmed, Ain Munir Abbasi Sabahat Ul, Zahid Tabeer, Ahmed Raheel
Islamic International Medical College, Rawalpindi, Pakistan.
All India Institute of Medical Sciences, Bhubaneswar, India.
World J Surg. 2025 Jul 28. doi: 10.1002/wjs.70023.
Appendicitis remains a common surgical emergency with potentially fatal complications. Long-term trends in mortality disparities are not well characterized. We analyzed demographic and regional disparities in appendicitis-related mortality in the United States from 1999 to 2020 using CDC WONDER data.
We performed a retrospective analysis of death-certificate data for individuals aged ≥ 25 years, identifying appendicitis-related deaths (ICD-10 K35-K37). Age-adjusted mortality rates (AAMRs) per 100,000 population were standardized to the 2000 U.S.
Joinpoint regression estimated annual percentage changes (APCs) and average APCs (AAPCs) with 95% confidence intervals. Analyses were stratified by sex, race/ethnicity, urbanization, and state.
From 1999 to 2020, 15,243 appendicitis-related deaths occurred (6643 females and 8600 males). Overall AAMR declined from 0.38 to 0.32 per 100,000 (AAPC -1.38% and 95% CI -3.10 to 0.36). A significant decrease occurred from 1999 to 2018 (APC-2.81% and p < 0.0001), followed by a nonsignificant rise. Males exhibited a consistent decline (AAPC -2.88% and p < 0.0001), whereas females experienced an increase from 2016 to 2020 (APC +5.94% and p < 0.0001). Black individuals had the highest AAMR (0.38) but a significant decline (AAPC -3.73% and p < 0.0001) compared to Whites (AAPC -2.49% and p < 0.0001) and Hispanics (AAPC -2.06% and p < 0.0001). Nonmetropolitan areas had higher AAMR (0.34) than metropolitan areas (0.31). Vermont and New Mexico recorded the highest state-level AAMRs; New Jersey and Louisiana had the lowest.
Appendicitis-related mortality in the United States declined over two decades; however, rising mortality among females since 2016 and persistent racial and regional disparities underscore the need for targeted interventions to ensure equitable access to timely surgical care.
阑尾炎仍是一种常见的外科急症，可能引发致命并发症。死亡率差异的长期趋势尚未得到充分描述。我们使用美国疾病控制与预防中心（CDC）的WONDER数据，分析了1999年至2020年美国阑尾炎相关死亡率的人口统计学和地区差异。
我们对年龄≥25岁个体的死亡证明数据进行了回顾性分析，确定与阑尾炎相关的死亡（国际疾病分类第十版[ICD-10]编码K35-K37）。每10万人的年龄调整死亡率（AAMR）按照2000年美国标准进行标准化。
Joinpoint回归估计年度百分比变化（APC）和平均APC（AAPC）及其95%置信区间。分析按性别、种族/族裔、城市化程度和州进行分层。
1999年至2020年，共发生15243例与阑尾炎相关的死亡（女性6643例，男性8600例）。总体AAMR从每10万人0.38降至0.32（AAPC为-1.38%，95%置信区间为-3.10至0.36）。1999年至2018年出现显著下降（APC为-2.81%，p<0.0001），随后出现不显著的上升。男性呈现持续下降趋势（AAPC为-2.88%，p<0.0001），而女性在2016年至2020年有所上升（APC为+5.94%，p<0.0001）。黑人的AAMR最高（0.38），但与白人（AAPC为-2.49%，p<0.0001）和西班牙裔（AAPC为-2.06%，p<0.0001）相比，下降幅度更大（AAPC为-3.73%，p<0.0001）。非都市地区的AAMR（0.34）高于都市地区（0.31）。佛蒙特州和新墨西哥州的州级AAMR最高；新泽西州和路易斯安那州最低。
美国与阑尾炎相关的死亡率在二十年里有所下降；然而，2016年以来女性死亡率上升以及持续存在的种族和地区差异凸显了采取针对性干预措施的必要性，以确保公平获得及时的外科治疗。
