The influence of age and gender on normal appendicectomy rates.

Epidemiological data from a retrospective analysis of 1307 pathology reports of appendicectomy specimens from four Hunter Valley Hospitals, having a 100% tissue audit, showed that there was a significant difference in normal appendicectomy (histologically normal appendix following appendicectomy for suspected acute appendicitis) rates for the young (male and female 0-12 years) and reproductive female (13-50 years) groups when compared with the elderly (over 60 years) and the rest (male 13-59, female 51-59 years) of the population. The overall normal appendicectomy rate was 26%, and the perforation rate 3.6%. These data suggest that suspected acute appendicitis in the Hunter Valley is managed in an appropriate way. The perforation rate was significantly higher in the elderly group, and management of these patients will remain a problem due to delayed and atypical presentation. Continuing audit programmes and area-wide review should contribute to improved accuracy in the diagnosis of acute appendicitis.