RESUMEN
To describe the epidemiology of appendicitis and appendectomy in the United States, the authors analyzed National Hospital Discharge Survey data for the years 1979-1984. Approximately 250,000 cases of appendicitis occurred annually in the United States during this period, accounting for an estimated 1 million hospital days per year. The highest incidence of primary positive appendectomy (appendicitis) was found in persons aged 10-19 years (23.3 per 10,000 population per year); males had higher rates of appendicitis than females for all age groups (overall rate ratio, 1.4:1). Racial, geographic, and seasonal differences were also noted. Appendicitis rates were 1.5 times higher for whites than for nonwhites, highest (15.4 per 10,000 population per year) in the west north central region, and 11.3% higher in the summer than in the winter months. The highest rate of incidental appendectomy was found in women aged 35-44 years (43.8 per 10,000 population per year), 12.1 times higher than the rate for men of the same age. Between 1970 and 1984, the incidence of appendicitis decreased by 14.6%; reasons for this decline are unknown. A life table model suggests that the lifetime risk of appendicitis is 8.6% for males and 6.7% for females; the lifetime risk of appendectomy is 12.0% for males and 23.1% for females. Overall, an estimated 36 incidental procedures are performed to prevent one case of appendicitis; for the elderly, the preventive value of an incidental procedure is considerably lower.
Asunto(s)
Apendicectomía/estadística & datos numéricos , Apendicitis/epidemiología , Adolescente , Adulto , Factores de Edad , Anciano , Niño , Preescolar , Métodos Epidemiológicos , Femenino , Humanos , Tablas de Vida , Estudios Longitudinales , Masculino , Persona de Mediana Edad , Factores Sexuales , Estados UnidosRESUMEN
Campylobacter jejuni is the most common enteric pathogen isolated from university and college students in the United States. During the fall and winter quarters of the 1983-1984 academic year, the authors conducted a case-control study at the University of Georgia, Athens, Georgia, to identify risk factors for C. jejuni enteritis. Students with diarrhea whose cultures yielded C. jejuni were compared with controls matched by age, sex, and residence. A total of 45 case-control pairs were interviewed about exposures during the week before the case's onset of illness. The infections occurred sporadically and were caused by a wide variety of C. jejuni serotypes. Three risk factors were identified: eating fully cooked chicken, eating chicken reported to be raw or undercooked, and contact with a cat or kitten. No case reported drinking raw milk. No significant association was found between illness and the places where chicken meals were prepared or the specific manner in which chicken was cooked. Chicken may be the principal vehicle of transmission for sporadic Campylobacter enteritis among college students.