Clinicopathological Aspects of Acute Appendicitis in Patients Above Age of Thirty at Sulaimani Emergency Hospital

Senior House Officer of Trauma and Emergency Surgery

Aims of this study are :

• Estimate the incidence of A.A. in patients above age of 30 y in 4 age groups .
• Correlate between different clinical aspects and histopathological results.
• Determine rate of negative appendectomy in those patients.

Study Overview

• Status: Unknown
• Conditions: Acute Appendicitis in Elderly
• Intervention / Treatment: Procedure: Appendectomy

Detailed Description

Acute appendicitisis the clinical condition which refer to inflammation of the vermiform appendix1. It is the most common abdominal emergency2,3,4 .it accounts for more than 40,000 hospital admissions in England every year 5 . Approximately 8% of the population in Western countries would have appendicitis during their life 6 .In the United States, the estimated incidenc of acute appendicitis is 11 cases per 10,000 population 5 . However, in South Africa, the incidencewas estimated to be less than 9 per 100,000 6 .Appendectomy is considered the most common emergency surgical procedure worldwide6,8 ,9. The cause of acute appendicitis is unknown but it is multifactorial; luminal obstruction , dietary and familial factors have been suggested 5 . Fecoliths are the most common cause of obstruction. It was demonstrated that the mean duration of abdominal pain in patients with gangrenous appendix is 46.2 hours and 70.9 hs for perforated 7 .

The peak incidence of acute appendicitis is at the age of 10 to 30 years 6,10. There are special features for appendicitis according to age 1. A.A is primarily a disease of the younger population, with only 5-10% of cases occurring in elderly people, but the incidence of acute appendicitis in elderly began to increase with the increase in life expectancy14. Older patients with acute abdominal pain are high-risk patients, unlike their younger counterparts15 . Morbidity and mortality rates are greater in elderly due to atypical presentations and delay in diagnosis leading to increase rate of perforation and intra-abdominal infection.. They need to be clinically evaluated by experienced surgeons within a narrow time margin14,15.

• Study Type: Observational
• Enrollment (Anticipated): 70

Contacts and Locations

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 30 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

• Sampling Method: Non-Probability Sample

Study Population

The study includes 70 patients with age above than thirty years old. The patients are divided into 4 age groups :group 1 (30-39 y) , group 2(40-49), group 3(50-59) and group4 (patients older than 60 y) .They were admitted to our emergency hospital with features of acute appendicitis. A detailed history was taken and clinical examination of the patient was carried out at the time of admission .Data was collected regarding investigations (CBC , GUE , US). Appendectomy done for the 70 patient,their operative findings along with any complications as well as histopathological findings were recorded

Description

Inclusion Criteria:

• patients above age of thirty appendectomy done for them

Exclusion Criteria:

• patients less than thirty years conservative mangement

Study Plan

How is the study designed?

Design Details

• Observational Models: Cohort
• Time Perspectives: Prospective

Number of groups / cohorts

4

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
fourth decade; appendectomy done , appendix send for histopathological examination	Procedure: Appendectomy; patients diagnosed as acute appendicitis , appendectomy done
fifth decade; appendectomy done , appendix send for histopathological examination	Procedure: Appendectomy; patients diagnosed as acute appendicitis , appendectomy done
sixth decade; appendectomy done , appendix send for histopathological examination	Procedure: Appendectomy; patients diagnosed as acute appendicitis , appendectomy done
older than 60 years; appendectomy done , appendix send for histopathological examination	Procedure: Appendectomy; patients diagnosed as acute appendicitis , appendectomy done

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Clinico -pathological aspects of acute appendicitis in patients above age of thirty in Sulaimani Emergency hospital	perform appendectomy for all the patients who diagnosed as acute appendicitis	2 month

Collaborators and Investigators

• Sponsor: University of Sulaimani

Study record dates

Study Major Dates

• Study Start (Anticipated): July 1, 2019
• Primary Completion (Anticipated): August 1, 2019
• Study Completion (Anticipated): August 1, 2019

Study Registration Dates

• First Submitted: July 23, 2019
• First Submitted That Met QC Criteria: July 23, 2019
• First Posted (Actual): July 25, 2019

Study Record Updates

• Last Update Posted (Actual): July 25, 2019
• Last Update Submitted That Met QC Criteria: July 23, 2019
• Last Verified: July 1, 2019

More Information

Terms related to this study

• Keywords: Clinico-pathology , acute appendicitis , elderly , aging , histopathology
• Additional Relevant MeSH Terms: Digestive System Diseases; Pathologic Processes; Infections; Disease Attributes; Gastrointestinal Diseases; Gastroenteritis; Intestinal Diseases; Cecal Diseases; Intraabdominal Infections; Emergencies; Acute Disease; Appendicitis
• Other Study ID Numbers: AA8

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No