EPIDEMIOLOGY AND SEASONAL VARIATION OF APPENDICITIS – A SINGLE CENTER RETROSPECTIVE STUDY FROM NORTH-EAST INDIA
Keywords:acute appendicitis (AA), pre-monsoon season, monsoon season, Indian Meteorological Department (IMD)
Background. Acute appendicitis is the most common surgical emergency presenting in emergency department, and appendectomy is one of the most common surgeries. There is a wide variation in the incidence of acute appendicitis reported for different countries, different regions, race, sex, age and also seasons.
Objective. The aim of this study was to understand the epidemiological trend and the seasonal variation of appendicitis in the northeast region of India.
Methods. It was a retrospective hospital-based study conducted in Jan 2016 – Dec 2020 at a Tertiary Care Teaching Hospital in the northeast region of India. The patient data were obtained from the Medical Record Department of the hospital and the data regarding the weather was obtained from the Indian Meteorological Department (IMD) and the website www.worldweather.com. The statistical analysis was done using SPSS software version 24.0, and the seasonal variation was studied using Kruskal Wallis test.
Results. Acute appendicitis affected both the sexes equally with a marginal higher incidence in males. It also had higher peak during the second and third decade of life in both the sexes. The incidence of acute appendicitis was high in the pre-monsoon and monsoon season with peak in the monsoon season.
Conclusions. Acute appendicitis is more common during the pre-monsoon and monsoon season, a period known for humidity, high incidence of bacterial and viral infections.
Sihrah BH, Shirah HA, Shirah HA et al. Challenges in the management of subhepatic acute appendicitis in the emergency setting. Int J Cur Res Rev 2016 Mar;8(6)
Addiss DG, Shaffer N, Fowler BS, Tauxe RV. The epidemiology of appendicitis and appendectomy in the United States. Am J Epidemiol. 1990 Nov;132(5): 910-925.
Brunicardi FC, Anderson DK, Billiar TR. The Appendix. In: Liang MK, Anderson RE, Jaffe BM et al. Schwartz’s Principle of Surgery.10th ed. Mc Graw Hill Education Medical. 2015. p. 1241-1262.
Jones BA, Demetriades D, Segal I, et al. The prevalence of appendiceal fecaliths in patients with and without appendicitis: A comparative study from Canada and South Africa. Ann Surg. 1985 Jul;202(1):80-2.
Nitecki S, Karmeli R, Sarr MG. Appendiceal calculi and fecaliths as indications for appendectomy. Surg Gynecol Obstet 1990 Sep;171(3):185-8. PMID: 238510
Wangensteen OH, Dennis C. Experimental proof of the obstructive origin of appendicitis in man. Ann Surg. 1939 Oct;110(4):629–647.
Burkitt DP, Walker AR, Painter NS. Effect of dietary fibres on stool and transit times, and it’s role in the causation of the disease. Lancet 1972 Dec 30;2(7792):1408-12.
Oldmeadow C, Wood I, Mengerson K, Visscher PM, Martin NG, Duffy DL. Investigation of the relationship between smoking and appendicitis in Australian twins. Ann Epidemiol 2008 Aug;18(8):631-6.
Kaplan GG, Dixon E, Panaccione R, et al. Effect of ambient air pollution on the incidence of appendicitis. CMAJ 2009 Oct 27;181(9):591-7.
https://doi.org/10.1503/cmaj.082068.Epub 2009 Oct 5.
Luckmann R, Davis P. The epidemiology of acute appendicitis in California: racial, gender, and seasonal variation. Epidemiology 1991;2(5):323-30.
Wei PL, Chen CS, Keller JJ, et al. Monthly variation in acute appendicitis incidence: A 10-year nationwide population-based study. J Surg Res. 2012 Dec;178(2):670-6.
https://doi.org/10.1016/j.js.2012.06.034.Epub 2012 Jul 6.
Khaeval AA, Birkenfeldt RR. Nature of the relation of acute appendicitis morbidity to meterological and heliogeophysical factors. Vestn Khir Im I I Grek 1978 Apr;120(4):67-70. PMID: 654016
Stein GY, Rath-Wolfson L, Zeidman A et al. Sex differences in the epidemiology, seasonal variation, and trends in the management of patients with acute appendicitis. Langenbecks Arch Surg 2012 Oct;397(7):1087–1092.
Singh TB, Ratan R. Acute appendicitis: Epidemiological trends and seasonal variation in subset of South western part of India. IJSR 2018(Oct) Vol-7:10
Townsend CM, Beauchamp RD, Evers BM, et al. The Appendix. In: Maa J, Kirkwood KS. Sabiston Textbook of Surgery. 19th ed. Philadelphia: Elsevier; 2012. p.1279-1293.
Badmos KB, Komolafe AO, Rotimi O. Schistosomiasis presenting as acute appendicitis. The East African Med J 2006;83(10):528-32.
Wangensteen OH, Buirge RE, Dennis C, et al. Studies in the etiology of acute appendicitis: the significance of the structure and function of the vermiform appendix in the genesis of appendicitis. Ann Surg. 1937 Nov;106(5):910–942.
Alves JG, Figueiroa JN, Barros I. Does breast feeding provide protection against acute appendicitis? A case control study. Trop Doct 2008 Oct;38(4):235-6.
Pearnteau WH, Smink DS. Appendix, Meckel’s, and other small bowel diverticula. In: Michael J. Zinner, Stanley W. Ashley,eds. Maingot’s Abdominal Operations. 12th ed. Mc Graw Hill Medical; 2013. p. 585-610.
Williams NS, Bulstrode CJK, O’Connell PR. Bailey and Love’s Short practice of Surgery. 26th ed. Boca Raton; CRC Press, 2013. Chapter 71: The vermiform appendix; p. 1199-1214.
Fasen G, Schirmer B, Hedrick TL. Appendix. In: Charles J. Yeo, Samuel D. Gross, eds. Shackelford’s Surgery of the Alimentary Canal. 8th ed. Philadelphia: Elsevier; 2018. p. 1950-56Noudeh YJ, Sadigh N, Ahmadnia AY. Epidemiologic features, seasonal variations and false positive rate of acute appendicitis in Shahr-e-Rey, Tehran. Int J Surg 2007:5:95-8.
Luckmann R, Davis P. The epidemiology of acute appendicitis in California: Racial, gender, and seasonal variation. Epidemiology 1991;Sep;2(5):323-30.
Jangra B, Jangra MS, Rattan KN et al. Seasonal and day of week variations in acute appendicitis in north Indian children. J Indian Ass Plastic Surgeon. 2013(Jan-Mar);Vol 18:1.
Kwaasi AA, Tipirnemi P, Harfi H, Parhar RS, Alsedairy ST. Date palm (Phoenixdactylifera L) is a potent allergen. Ann Allergy 1992;68:78.
Oguntola A S, Adeoti M L, Oyemolade TA. Appendicitis: Trends in incidence, age, sex, and seasonal variations in south-Western Nigeria. Ann Afr Med Oct-Dec 2010;9(4):213-7.
Noudeh YJ, Sadigh N, Ahmadnia AY. Epidemiologic features, seasonal variations and false positive rate of acute appendicitis in Shahr-e-Rey, Tehran. Int J Surg 2007 Apr;5(2):95-8.
Gomez-Alcala AV, Hurtado-Guzman A. Early breastfeed weaning as a risk factor for acute appendicitis in children. Gac Med Mex. Nov-Dec 2005;141(6): 501–4.
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