The amount of comorbidities as a single parameter has no effect in predicting the outcome in appendicitis patients older than 60 years.

BACKGROUND: Retrospective analysis of acute appendicitis patients older than 60 and statistical evaluation of the association between the accompanying illnesses, severity of peritonitis, morbidity, and mortality rates. INTRODUCTION: Although acute appendicitis is not frequent among aged populations, accompanying comorbidities of the geriatric patients are always fear factors before an emergency abdominal surgery even for acute appendicitis. METHODS: The data of the 27 patients older than 60 years who underwent appendectomy were retrospectively analyzed. The patients were grouped according to the total number of their comorbidities, Mannheim peritonitis index scores, and the period between the onset of abdominal pain and the admission to the hospital. RESULTS: The mean age of the patients was 73 years. The morbidity and mortality rates were statistically significantly higher in perforated cases. The comparison of patients with or=2 comorbidities did not show any statistical difference in morbidity and mortality. The sensitivity, specificity, positive predictive value, and negative predictive values for mortality in geriatric acute appendicitis patients with Mannheim peritonitis index scores greater than 26 were found to be 75%, 86%, 50%, and 95%, respectively. DISCUSSION: Retrospective evaluation of geriatric patients with acute appendicitis, according to the total number of their comorbidities, surprisingly revealed no statistical difference between groups. We thought that a high Mannheim peritonitis index score is a more reliable criteria than the total number of comorbidities in predicting the prognosis of patients with acute appendicitis in the geriatric population.

Hepatic hydatid disease in children and adults living in different areas in Turkey.

OBJECTIVE: To compare the clinical features of the hepatic hydatid disease in the operated children and adults living in the east and west part of Turkey. METHODS: Between January 2001 and May 2005, 105 patients were operated with the diagnosis of hepatic hydatid cyst in Trakya and Yuzuncu Yil University Hospitals, Turkey. The patients (n=105) were retrospectively evaluated in 4 groups; Edirne Ch: (18 children under 18 year-old) and Edirne Ad: (20 adults) were from Edirne, Van Ch: (22 children under 18 year-old) and Van Ad: (44 adults) from Van. The patients in each group were analyzed according to their clinical and radiological findings. RESULTS: The frequency of hepatic hydatid cysts in children was significantly higher in boys in Edirne Ch group and in girls in Van Ch group (p<0.05). In adults, the disease was also seen significantly higher in males in Edirne Ad group and females in Van Ad group (p<0.05). There were no difference symptoms of the disease, concomitant extra hepatic cysts and total cyst number in children and adults in the same region (p>0.05). The number of huge hepatic cysts and history of contact with animal were more common in children and adults living in Van. CONCLUSION: While the course of hepatic hydatid disease has the similar clinical features among the children and adults in the same region, remarkable regional differences have been found on it.