Key result
Appendectomy linked to ~27% lower CV event risk in patients over 60.
Why the study?
The appendix may influence cardiovascular health via immune function, but whether appendectomy is associated with cardiovascular risk remained unclear.
Does appendectomy reduce overall cardiovascular events in hospital patients aged ≥60 years?
Cohort (n=978,095)
Yes
Does appendectomy reduce overall cardiovascular events in hospital patients aged ≥60 years?
Appendectomy in patients aged 60 years and older is associated with a significantly lower multivariate-adjusted risk for overall cardiovascular events, myocardial infarction, and stroke.
Answers are grounded in this paper and cite their sources.
Associated lower CV risk after appendectomy in elderly patients should not yet change practice; leaves open causality and requires prospective confirmation.
Background The appendix is thought to contribute to gut and systemic immune system function, and thus could influence cardiovascular health and disease progression. However, it is unclear if there is an association between appendectomy and cardiovascular risk. This study aimed to estimate the strength of any such association in 978,095 Australian hospital patients aged ≥60 years, among which 5,130 underwent appendectomy. Methods The association of appendectomy with cardiovascular events (myocardial infarction, angina, stroke and transient ischemic attack) was analysed using binary logistic regression adjusting for age, sex, cardiovascular risk factors, and gastrointestinal disorders. Results Appendectomy was inversely associated with overall cardiovascular risk (odds ratio [OR], 0.73; 95% confidence interval [CI], 0.66-0.81; P<0.001), myocardial infarction (OR, 0.71; 95% CI, 0.63-0.80; P<0.001) and stroke (OR, 0.77; 95% CI, 0.66-0.90; P=0.001) after adjustment for all the test confounders. This inverse association existed in both sexes and remained when hernia surgery was used as a control instead of patients without appendectomy. Conclusions This study found that appendectomy was associated with >27% lower multivariate-adjusted risk for overall cardiovascular events, myocardial infarction, or stroke, in patients aged 60 years and over. Our results provide additional support for the current clinical practice of removing the appendix in the elderly when appendicitis is suspected.
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Judkins et al. (2025) conducted a cohort in Cardiovascular events (n=978,095). Appendectomy vs. No appendectomy was evaluated on Overall cardiovascular events (myocardial infarction, angina, stroke, and transient ischemic attack) (OR 0.73, 95% CI 0.66-0.81, p=<0.001). Appendectomy was associated with a 27% lower multivariate-adjusted risk for overall cardiovascular events (OR 0.73) compared to no appendectomy in patients aged 60 years and over.
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