Changes in the Epidemiology of Acute Appendicitis and Appendectomy in Danish Children 1996–2004

Abstract

Purpose: Aim of the study was to describe changes in the epidemiology of acute appendicitis in Danish children between 0-19 years of age for the period 1996–2004.

Methods: The study was based on discharge diagnoses taken from the Danish National Patient Registry of all 28 274 patients with a diagnosis of acute uncomplicated or complicated appendicitis, and/or a registered procedure code of appendectomy. These data were computed together with data on the background population, and incidences were calculated.

Results: A significant decrease in the incidence of acute uncomplicated appendicitis was found for all age groups (range, 13–36%). The decrease was present for both sexes, but most prominent in girls. The incidence of complicated acute appendicitis decreased by 10%.

Conclusion: The incidence of acute appendicitis is declining. The incidence of uncomplicated appendicitis appears to be declining more rapidly than that of complicated appendicitis. This finding does not necessarily imply poorer management of the disease, but–as suggested by others–could be due to different behaviours of uncomplicated and complicated appendicitis.

Key words

appendicitis - perforated appendicitis - appendectomy - incidence - children

References

• 1 Al-Omran M, Mamdani MM, McLeod RS. Epidemiologic features of acute appendicitis in Ontario, Canada.  Can J Surg. 2003;  46 263-268
• 2 Andersson R, Hugander A, Thulin A. et al . Indications for operation in suspected appendicitis and incidence of perforation.  BMJ. 1994;  308 107-110
• 3 Andersson RE. The natural history and traditional management of appendicitis revisited: spontaneous resolution and predominance of prehospital perforations imply that a correct diagnosis is more important than an early diagnosis.  World J Surg. 2007;  31 86-92
• 4 Arnbrörnsson E, Asp N, Westin SI. Decreasing incidence of acute appendicitis, with special reference to the consumption of dietary fiber.  Acta Chir Scand. 1982;  2148 461-464
• 5 Arnbjörnsson E. Epidemiology of appendicitis.  Läkartidningen. 1983;  80 4278-4279
• 6 Bakken IJ, Skjeldestad FE, Mjåland O. et al . Appendisitt og appendektomi i Norge 1990–2001.  Tidsskr Nor Lægeforen. 2003;  123 3185-3188
• 7 Blomqvist P, Ljung H, Nyrén O. et al . Appendectomy in Sweden 1989–1993 assessed by the inpatient registry.  J Clin Epidemiol. 1998;  51 859-865
• 8 Körner H, Söndenaa K, Söreide JA. et al . Incidence of acute nonperforated and perforated appendicitis: Age-specific and sex-specific analysis.  World J Surg. 1997;  21 313-317
• 9 Körner H, Söreide JA, Pedersen EJ. et al . Stability in incidence of acute appendicitis.  Digestive Surgery. 2001;  18 61-66
• 10 Livingston EH, Woodward WA, Sarosi GA. et al . Disconnect between incidence of nonperforated and perforated appendicitis. Implications for pathophysiology and management.  Ann Surg. 2007;  245 886-892
• 11 Noer T. Decreasing incidence of acute appendicitis.  Acta Chir Scand. 1975;  141 431-432
• 12 Pieper R, Kager L. The incidence of acute appendicitis and appendectomy. An epidemiological study of 971 cases.  Acta Chir Scand. 1982;  148 45-49
• 13 Rasmussen S, Madsen M. Registre inden for sundhedsområdet. Copenhagen (Denmark): Dansk Institut for Klinisk Epidemiologi 1997

Correspondence