Dhar, A.; Hoare, J.; Majeed, A.; Williamson, R.C.N.; Maxwell, J.D.; Kang, J.Y.
April 2003
Gut;Apr2003 Supplement 1, Vol. 52, pA94
Academic Journal
Background: The incidence of acute appendicitis declined in Western countries from the 1930s to the 1980s. However, it has been argued that this could in part be due to some patients being reclassified as having non-specific abdominal pain (NSAP) or mesenteric lymphadenitis (ML). Aim: To determine time trends in hospital admissions for acute appendicitis in England from 1989/90 to 1999/2000. Methods: Hospital episode statistics for admissions were obtained from the Department of Health. Results: Between 1989/90 and 1999/2000, age-standardised hospital admission rated for acute appendicitis decreased by 12% for males and 19% for females. The admission rates for ML decreased by 40% and 41%, respectively. Coding for NSAP was changed in 1995/1996. From 1989/90 to 1994/1995, NSAP admissions increased by 4.7% for males and 4.9% for females. Over the same period admissions for acute appendicitis decreased by 8.3% for males and 11.4% for females. The increase in NSAP admissions occurred among subjects aged > 34 years, with a decline among those aged 5-19 years. There was a decline in appendicitis among all age groups, especially marked for those aged < 25 and > 84 years. Conclusions: Admission rates for acute appendicitis have continued to fall in the 1990s. This fall cannot be accounted for by an increased tendency to diagnose ML or NSAP.


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