Effect of the presence of morbidity on complication development in geriatric patients with acute appendicitis

Abstract

Objective: In this study, we aimed to evaluate the patients aged 65 years and older who underwent surgery for acute appendicitis. Material and Methods: The data of the 33 patients aged 65 years and older who underwent appendectomy for acute appendicitis between January 2011 and December 2014 were retrospectively analyzed. The demographic data, duration of complaint, comorbid diseases, operative findings, the period between the onset of abdominal pain and the admission to the hospital, duration of hospital stay, complications and mortality rates were evaluated. Patients were divided into 2 groups according to their comorbidity status. Results: There were 21 female and 12 male patients. The mean age of the patients was 73.9 years (range: 65-89 years). Of the patients, 10 patients had diabetes mellitus, 16 had hypertension, 3 patients had heart / valve disease, 3 had COPD and 2 had cerebrovascular disease. Appendectomy was performed with laparoscopy in 7 patients, with Mc Burney's incision in 14 patients and 11 patients were operated with median incision; in 1 patient, the operation was initiated with laparoscopy then proceeded with Mc Burney's incision. Ultrasound examination revealed acute appendicitis in 22 patients. Computed tomography was performed in 19 patients. The mean period of hospital stay was 5.66 days (range: 1-33 days). Eight of the patients were followed up in postoperative intensive care unit (ICU). Six patients developed wound infection and 2 patients developed intra-abdominal abscess. All complications were seen in group 1. There was a statistically significant difference between the groups (p<0.05). Mortality occurred in 1 patient. Conclusion: Because of the high rate of complication in the presence of morbidity, the importance of preoperative evaluation, optimum preoperative care and completion of prophylaxis and incision selection according to the patient can reduce the rate of complication.