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

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.

Akut apandisitli geriatrik hastalarda morbidite varlýðýnýn komplikasyon geliþimine etkisi

Amaç: Bu çalýþmada, 65 yaþ ve üzeri akut apandisit nedeniyle ameliyat edilen hastalarýn deðerlendirilmesi amaçlandý.
Gereç ve Yöntemler: Ocak 2011-Aralýk 2014 tarihleri arasýnda 65 yaþ ve üzeri akut apandisit nedeniyle ameliyat edilen 33 hasta retrospektif olarak deðerlendirildi. Hastalarýn demografik verileri, þikayet süreleri, komorbid hastalýklarý, operasyon bulgularý, karýn aðrýsý baþlangýcý ile hastaneye baþvuru arasýndaki süre, yatýþ süreleri, komplikasyonlar ve mortalite geliþimi deðerlendirildi. Komorbidite durumuna göre
hastalar, 2 gruba ayrýldý.
Bulgular: Hastalarýn 21’i kadýn ve 12’si erkek idi. Ortalama yaþý 73.9 (aralýk 65-89) idi. Hastalarýn 10’unda Diabetes mellitus, 16’sýnda hipertansiyon, 3 hastada kalp/ kapak hastalýðý, 3 hastada KOAH ve 2 hastada serebrovasküler hastalýk mevcuttu. Apendektomi, 7 hastada laparoskopik, 14 hastada Mc Burney, 11 hastada median insizyonla yapýldý ve 1 hastada laparoskopik baþlanýp Mc Burney insizyonla ameliyat edildi. Ultrasonografik incelemede, 22 hastada akut apandisit saptandý. Bilgisayarlý tomografi, 19 hastaya çekildi. Ortalama hastanede yatýþ süresi 5.66 (1-33) gündü. Hastalarýn 8’i postoperatif yoðunbakým ünitesinde takip edildi. Altý hastada yara yeri enfeksiyonu ve 2 hastada batýn içi apse geliþti. Tüm komplikasyonlar grup 1’de görüldü. Gruplar arasýnda istatistiksel olarak anlamlý farklýlýk saptandý (p<0.05).
Mortalite 1 hastada görüldü.
Sonuç: Morbidite varlýðýnda komplikasyon oraný yüksek olduðundan preoperatif deðerlendirmeye önem verilmesi, hastanýn optimum preop bakýmýnýn profilaksinin, tamamlanmasý, insizyon seçiminin hastaya göre yapýlmasý komplikasyon oranýný azaltabilir.