Scher K S, Coil J A
South Med J. 1980 Dec;73(12):1561-3.
The mortality from perforating appendicitis has decreased, but the incidence of perforation has not changed in 30 years. We found that among 335 consecutive patients treated for acute appendicitis, 108 (32%) had evidence of perforation. No significant differences between the groups were noted with respect to race, sex, educational level, family income, health insurance coverage, availability of transportation, and possession of a telephone. Perforation was more likely in patients who lived more than 20 miles from the hospital and in patients under age 10 years or over age 60. Patients with perforation were ill for a mean of 2.5 days before seeking medical attention, compared to a mean of 1.5 days for those without perforation (P < .001). Yet, approximately 75% of patients in each group stated that they had a "family doctor." Patients with perforation had significantly more physician visits before hospital admission (mean 1.61 vs 1.33, P < .005); 54.3% of patients with perforation had previous contact with a physician who failed to make the correct diagnosis.
穿孔性阑尾炎的死亡率有所下降，但穿孔的发生率在30年里并未改变。我们发现，在连续接受急性阑尾炎治疗的335例患者中，108例（32%）有穿孔迹象。在种族、性别、教育程度、家庭收入、医疗保险覆盖范围、交通便利性和是否拥有电话方面，各群体之间未发现显著差异。距离医院超过20英里的患者以及10岁以下或60岁以上的患者更易发生穿孔。穿孔患者在寻求医疗救治前平均患病2.5天，而未穿孔患者平均患病1.5天（P < .001）。然而，每组中约75%的患者表示他们有“家庭医生”。穿孔患者在入院前看医生的次数明显更多（平均1.61次对1.33次，P < .005）；54.3%的穿孔患者之前曾接触过未能做出正确诊断的医生。
