A Retrospective Study of Acute Appendicitis‐Related Mortality Among Older Adults in the United States: Regional and Demographic Patterns From 1999 to 2020

Objectives Although acute appendicitis has a lower incidence among older adults compared with those in younger age groups, there is emerging evidence to suggest that older adults bear greater morbidity and mortality. The purpose of this study was to gauge the differences in acute appendicitis‐related mortality among older individuals across different stratifications. Methods Death certificate data from 1999 to 2020 were accessed from the CDC WONDER database. Age‐adjusted mortality rates (AAMRs) per 100,000 people were obtained for each stratification and used to calculate annual percentage changes (APCs). Results There was an overall decrease in acute appendicitis‐related AAMR from 1999 to 2020, with an APC of −3.28 (95% confidence intervals [95% CI]: −3.85 to −2.70). The highest overall AAMRs (crude mortality rates in case of age) observed for each stratification were the following: men: 1.11 deaths per 100,000 (95% CI: 1.07–1.14), non‐Hispanic Black people: 0.92 deaths per 100,000 non‐Hispanic Black people (95% CI: 0.86–0.99), older adults aged 85 years and older: 2.15 deaths per 100,000 people (95% CI: 2.06–2.23), the Midwest and the West: 0.93 deaths per 100,000 people living in the Midwest and the West (95% CI: 0.89–0.98), Vermont: 1.36 deaths per 100,000 people living in Vermont (95% CI: 0.90–1.96) and non‐metropolitan areas: 1.05 deaths per 100,000 people living in Non‐metropolitan areas (95% CI: 1.00–1.10) with respect to sex, race, age, census region, individual states and urban–rural classification, respectively. Conclusions Acute appendicitis AAMRs for older adults had an overall decline between 1999 and 2020. Despite the overall decline in mortality rates, more research is needed to understand racial and economic disparities affecting clinical outcomes related to acute appendicitis.