Clinical characteristics of older Japanese patients with acute appendicitis: A post hoc analysis. (30th June 2021)

• Record Type: Journal Article
• Authors: Sasaki, Yosuke; Komatsu, Fumiya; Kashima, Naoyasu; Maeda, Tadashi; Honda, Yoshiko; Shimada, Nagato; Funahashi, Kimihiko; Urita, Yoshihisa
• Is Part Of: Journal of general and family medicine. Volume 23:Number 1(2022)
• Page Start: 19
• Page End: 23
• Publication Date: 2021-06-30
• Subjects: acute abdomen -- appendicitis -- C‐reactive protein -- geriatrics -- thrombocytopenia; Primary care (Medicine) -- Periodicals; Family medicine -- Periodicals; Family Practice; Primary Health Care; Japan; Periodicals; 610
• DOI: 10.1002/jgf2.477
• Languages: English
• ISSNs: 2189-7948

Abstract

Abstract: Background: Acute appendicitis (AA) in older patients can look different from AA in younger patients. Although it is crucial that primary care physicians can recognize AA in patients of any age, few Japanese studies have examined the characteristics of older AA patients. To address this, we evaluated the clinical characteristics of older Japanese patients with AA. Methods: We performed a post hoc analysis of the data from a previous Japanese single‐center study. We analyzed the clinical information of both younger (age: 16–64 years) and older patients (age: ≥65 years). Results: A cohort of 236 patients consisting of 219 (92.8%) younger patients and 17 (7.2%) older patients was evaluated. The median ages of the younger and older patients were 34 (interquartile range [IR], 24–45) and 78 years (IR, 74–81), respectively. The prevalence of complicated appendicitis (CA) (older: 41.2% vs. younger: 14.2%), comorbidities (70.6% vs. 13.2%), and thrombocytopenia (17.7% vs. 4.1%), along with serum C‐reactive protein (CRP) level (6.7 mg/dl vs. 1.0 mg/dl), was significantly higher in older patients. Significantly fewer older patients had epigastric pain (17.7% vs. 53.0%). Logistic regression evaluating the characteristics of older AA patients showed that CRP >5 mg/dl had a high odds ratio (OR) (5.01; 95% CI, 1.73–14.54), while epigastric pain had a low OR (0.24; 95% CI, 0.06–0.90). Conclusion: Our study reveals a higher prevalence of CA and comorbidities in older patients, and suggests that a lack of epigastric pain, thrombocytopenia, and higher serum CRP level are characteristics of older AA patients. Abstract : To examine the characteristics of older patients with acute appendicitis, we performed a post hoc analysis of the data from a previous Japanese single‐center study analyzing the clinical information of both younger (age: 16–64 years) and older patients (age: ≥65 years) with acute appendicitis. Our study reveals a higher prevalence of complicated appendicitis and comorbidities in older patients and suggests that a lack of epigastric pain, thrombocytopenia, and higher serum CRP level (>5 mg/dl) are characteristics of older patients.