Prognosis and Outcomes

Although perforation rates have not decreased over the past 70 years, mortality has decreased from 26% to less than 1% over the same period. Most of the morbidity and mortality associated from appendicitis is suffered by the very young and the

A retrospective review found a perforated appendix rate of 20%. Overall mortality was only 0.24%, but of the deaths reported, 93% occurred in the age group >50 years of age (Table 12.1). Of the patients with perforated appendicitis, the percentage of deaths in the same age group increased to 97%. The negative appendectomy rate was a consistent 22%.4

A large Department of Defense Study further characterized those most likely to perforate. In their study of almost 5000 appendectomies performed in DoD hospitals worldwide over a one year period ending 31 Jan 1993, the perforation rate was 21%. They were more likely to occur in the age group <8 years of age (38%) and in those >45 years of age (49%) than in those in-between (18%). Negative appendectomy rate in this study was 13%, and there were only 4 deaths (0.08%).5

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