Incidental appendectomy in the elderly? No.
This study examines the appropriateness of incidental appendectomy in the elderly. By examining the incidences of appendicitis and incidental appendectomy in 1977 in Wisconsin's elderly, this study calculated the chances that a citizen undergoing incidental appendectomy would have required otherwise an operation for appendicitis in his remaining lifetime. The 1977 incidences of appendicitis procedures and incidental appendectomy in citizens greater than or equal to 65 years were 0.78 and 1.59 per 1,000 population at risk. During 1977, 3.73 persons were spared an appendicitis operation in their remaining lifetimes because 3.82 incidental procedures were performed. This represents over 100 incidental procedures to avoid a single case of appendicitis. At a 1977-78 mortality rate of 3.5% for appendicitis in patients greater than or equal to 65 years, nearly 3,000 incidental procedures must be performed to save a life which would be lost to appendicitis otherwise. We doubt that incidental appendectomy in the elderly can be performed to better this threshold of risk. Therefore, we believe that incidental appendectomy is not indicated in the elderly, since it would appear that the risk of incidental appendectomy would outweigh its potential benefits.