Examining a common disease with unknown etiology: Trends in epidemiology and surgical management of appendicitis in California, 1995-2009

Jamie Anderson, Stephen W. Bickler, David C. Chang, Mark A. Talamini

Research output: Contribution to journalArticle

89 Citations (Scopus)

Abstract

Background The study was designed to examine the epidemiology of appendicitis and risk factors of perforation and appendectomy. Methods Retrospective analysis of the California Office of Statewide Health Planning and Development Patient Discharge Data was performed from 1995 to 2009. Patients with appendicitis were identified by ICD-9 diagnosis code. Population statistics from the RAND Corporation were used to calculate incidence rates. Risk factors of perforation and appendectomy were also calculated. Results A total of 608,116 patients with appendicitis (70 % non-perforated) were included. The incidence increased at an average rate of 0.5 cases/100,000 population/ year (p <0.001), with annual incidence peaking during the third quarter. Children age 10-14 had the highest rates of appendicitis (169.6 cases/100,000). The lifetime cumulative incidence rate is 9.0 %. Appendicitis is most common in whites and Hispanics and less common in African Americans and Asians. Risks of perforation include Hispanic or Asian race, young or old age, and nonprivate insurance. The adjusted odds of appendectomy increased since 1995 in patients with non-perforated appendicitis (OR 1.5, 95 % CI (1.3-1.7); p <0.001), but it decreased in patients with perforated appendicitis (OR 0.4, 95 % CI (0.4-0.5); p <0.001). Conclusions This is the largest epidemiological study of appendicitis to our knowledge in recent years. Incidence has increased over time and is higher in the summer months. Whites and Hispanics have higher rates of appendicitis, but Hispanics and Asians and patients with non-private insurance, have higher odds of perforation. Surgical management of perforated appendicitis has decreased over time. It is unknown why the incidence has increased, displays seasonality, and varies by race.

Original languageEnglish (US)
Pages (from-to)2787-2794
Number of pages8
JournalWorld Journal of Surgery
Volume36
Issue number12
DOIs
StatePublished - Jan 1 2012

Fingerprint

Appendicitis
Epidemiology
Hispanic Americans
Appendectomy
Incidence
Insurance
Health Planning
Patient Discharge
International Classification of Diseases
Population Characteristics
African Americans
Epidemiologic Studies

ASJC Scopus subject areas

  • Surgery

Cite this

Examining a common disease with unknown etiology : Trends in epidemiology and surgical management of appendicitis in California, 1995-2009. / Anderson, Jamie; Bickler, Stephen W.; Chang, David C.; Talamini, Mark A.

In: World Journal of Surgery, Vol. 36, No. 12, 01.01.2012, p. 2787-2794.

Research output: Contribution to journalArticle

@article{5b2d719d09f349988c3e22b0f1c91e4a,
title = "Examining a common disease with unknown etiology: Trends in epidemiology and surgical management of appendicitis in California, 1995-2009",
abstract = "Background The study was designed to examine the epidemiology of appendicitis and risk factors of perforation and appendectomy. Methods Retrospective analysis of the California Office of Statewide Health Planning and Development Patient Discharge Data was performed from 1995 to 2009. Patients with appendicitis were identified by ICD-9 diagnosis code. Population statistics from the RAND Corporation were used to calculate incidence rates. Risk factors of perforation and appendectomy were also calculated. Results A total of 608,116 patients with appendicitis (70 {\%} non-perforated) were included. The incidence increased at an average rate of 0.5 cases/100,000 population/ year (p <0.001), with annual incidence peaking during the third quarter. Children age 10-14 had the highest rates of appendicitis (169.6 cases/100,000). The lifetime cumulative incidence rate is 9.0 {\%}. Appendicitis is most common in whites and Hispanics and less common in African Americans and Asians. Risks of perforation include Hispanic or Asian race, young or old age, and nonprivate insurance. The adjusted odds of appendectomy increased since 1995 in patients with non-perforated appendicitis (OR 1.5, 95 {\%} CI (1.3-1.7); p <0.001), but it decreased in patients with perforated appendicitis (OR 0.4, 95 {\%} CI (0.4-0.5); p <0.001). Conclusions This is the largest epidemiological study of appendicitis to our knowledge in recent years. Incidence has increased over time and is higher in the summer months. Whites and Hispanics have higher rates of appendicitis, but Hispanics and Asians and patients with non-private insurance, have higher odds of perforation. Surgical management of perforated appendicitis has decreased over time. It is unknown why the incidence has increased, displays seasonality, and varies by race.",
author = "Jamie Anderson and Bickler, {Stephen W.} and Chang, {David C.} and Talamini, {Mark A.}",
year = "2012",
month = "1",
day = "1",
doi = "10.1007/s00268-012-1749-z",
language = "English (US)",
volume = "36",
pages = "2787--2794",
journal = "Presentations from the 9th Annual Electric Utilities Environmental Conference",
issn = "0364-2313",
publisher = "Springer New York",
number = "12",

}

TY - JOUR

T1 - Examining a common disease with unknown etiology

T2 - Trends in epidemiology and surgical management of appendicitis in California, 1995-2009

AU - Anderson, Jamie

AU - Bickler, Stephen W.

AU - Chang, David C.

AU - Talamini, Mark A.

PY - 2012/1/1

Y1 - 2012/1/1

N2 - Background The study was designed to examine the epidemiology of appendicitis and risk factors of perforation and appendectomy. Methods Retrospective analysis of the California Office of Statewide Health Planning and Development Patient Discharge Data was performed from 1995 to 2009. Patients with appendicitis were identified by ICD-9 diagnosis code. Population statistics from the RAND Corporation were used to calculate incidence rates. Risk factors of perforation and appendectomy were also calculated. Results A total of 608,116 patients with appendicitis (70 % non-perforated) were included. The incidence increased at an average rate of 0.5 cases/100,000 population/ year (p <0.001), with annual incidence peaking during the third quarter. Children age 10-14 had the highest rates of appendicitis (169.6 cases/100,000). The lifetime cumulative incidence rate is 9.0 %. Appendicitis is most common in whites and Hispanics and less common in African Americans and Asians. Risks of perforation include Hispanic or Asian race, young or old age, and nonprivate insurance. The adjusted odds of appendectomy increased since 1995 in patients with non-perforated appendicitis (OR 1.5, 95 % CI (1.3-1.7); p <0.001), but it decreased in patients with perforated appendicitis (OR 0.4, 95 % CI (0.4-0.5); p <0.001). Conclusions This is the largest epidemiological study of appendicitis to our knowledge in recent years. Incidence has increased over time and is higher in the summer months. Whites and Hispanics have higher rates of appendicitis, but Hispanics and Asians and patients with non-private insurance, have higher odds of perforation. Surgical management of perforated appendicitis has decreased over time. It is unknown why the incidence has increased, displays seasonality, and varies by race.

AB - Background The study was designed to examine the epidemiology of appendicitis and risk factors of perforation and appendectomy. Methods Retrospective analysis of the California Office of Statewide Health Planning and Development Patient Discharge Data was performed from 1995 to 2009. Patients with appendicitis were identified by ICD-9 diagnosis code. Population statistics from the RAND Corporation were used to calculate incidence rates. Risk factors of perforation and appendectomy were also calculated. Results A total of 608,116 patients with appendicitis (70 % non-perforated) were included. The incidence increased at an average rate of 0.5 cases/100,000 population/ year (p <0.001), with annual incidence peaking during the third quarter. Children age 10-14 had the highest rates of appendicitis (169.6 cases/100,000). The lifetime cumulative incidence rate is 9.0 %. Appendicitis is most common in whites and Hispanics and less common in African Americans and Asians. Risks of perforation include Hispanic or Asian race, young or old age, and nonprivate insurance. The adjusted odds of appendectomy increased since 1995 in patients with non-perforated appendicitis (OR 1.5, 95 % CI (1.3-1.7); p <0.001), but it decreased in patients with perforated appendicitis (OR 0.4, 95 % CI (0.4-0.5); p <0.001). Conclusions This is the largest epidemiological study of appendicitis to our knowledge in recent years. Incidence has increased over time and is higher in the summer months. Whites and Hispanics have higher rates of appendicitis, but Hispanics and Asians and patients with non-private insurance, have higher odds of perforation. Surgical management of perforated appendicitis has decreased over time. It is unknown why the incidence has increased, displays seasonality, and varies by race.

UR - http://www.scopus.com/inward/record.url?scp=84877134786&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84877134786&partnerID=8YFLogxK

U2 - 10.1007/s00268-012-1749-z

DO - 10.1007/s00268-012-1749-z

M3 - Article

C2 - 22948195

AN - SCOPUS:84877134786

VL - 36

SP - 2787

EP - 2794

JO - Presentations from the 9th Annual Electric Utilities Environmental Conference

JF - Presentations from the 9th Annual Electric Utilities Environmental Conference

SN - 0364-2313

IS - 12

ER -