APPENDECTOMY FOR ACUTE APPENDICITIS AND FOR OTHER CONDITIONS - AN EPIDEMIOLOGIC-STUDY

Background Appendicectomy is one of the commonest operations in most d eveloped countries, especially in children and young adults. We used r outine abstracts of hospital inpatient records to study the demographi c and temporal profiles of emergency appendicectomy for acute appendic itis and appendicectomy in other circumstances. Methods Records held i n the Oxford record linkage study (ORLS) from 1970-1986 inclusive were analysed. Age- and sex-specific admission rates were studied, subdivi ding appendicectomy into three main categories: emergency appendicecto my for acute appendicitis, emergency appendicectomy as the main operat ion without appendicitis recorded as a diagnosis, and prophylactic or incidental appendicectomy with other operations but without appendicit is. Results A total of 47 505 records of appendicectomy were analysed. Emergency appendicectomy for acute appendicitis was more common in ma les than females, peaked in the 10-19 year age groups, and declined ov er time. Emergency appendicectomy without appendicitis was more common in women than men (female to male ratio 1.8:1), peaked at age 15-19 y ears and did not decline over time. Incidental appendicectomy was much commoner in women (female to male ratio 3:1), peaked at older ages th an the first two groups, and declined significantly over time. Conclus ions The demographic profiles of patients in these categories were qui te different. The data on trends suggest confirmation of a true declin e in acute appendicitis, no decline for conditions which may mimic it, and a decline in the use of prophylactic and incidental appendicectom y. The operations in the latter categories-appendicectomy without acut e appendicitis-were much commoner in women than men and their appropri ateness would be worthwhile topics for medical audit.