Despite a global decline in age-standardized incidence rates, nearly half of the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) regions may have experienced an increase of appendicitis of more than 10%, according to a recent study.

In the study, published in The Lancet Gastroenterology & Hepatology, investigators assessed the burden of appendicitis globally, regionally, and nationally from 1990 to 2021. The research was conducted by the GBD 2021 Appendicitis Collaborator Group and aimed to provide a comprehensive analysis of appendicitis burden by age and sex.

The investigators used vital registration and verbal autopsy data, the Cause of Death Ensemble model, and demographic estimates from the GBD to estimate cause-specific mortality rates for appendicitis. Incidence data were gathered from insurance claims and inpatient discharge records, then analyzed using the DisMod-MR 2.1 disease modeling meta-regression tool. By combining mortality data with the expected remaining lifespan at the time of death, years of life lost (YLLs) were determined. Years lived with disability (YLDs) were calculated by multiplying the incidence rates by an average disease duration of 2 weeks and applying a specific disability weight for abdominal pain. Disability-adjusted life-years (DALYs) were estimated by summing YLLs and YLDs.

In 2021, the global age-standardized mortality rate for appendicitis was 0.358 per 100,000 (95% uncertainty interval = 0.311–0.414). Mortality rates varied by region, with the highest in central Latin America (1.01 per 100,000) and the lowest in high-income Asia Pacific (0.054 per 100,000). The global age-standardized incidence rate was 214 per 100,000, corresponding to approximately 17 million new cases. The highest incidence rate was observed in high-income Asia Pacific (364 per 100,000) and the lowest in western sub-Saharan Africa (81.4 per 100,000). Between 1990 and 2021, global age-standardized rates of mortality, incidence, YLLs, YLDs, and DALYs caused by appendicitis showed a continuous decline, with the most reduction in mortality and YLL rates. The largest annualized rate of decline in DALY rate was noted in pediatric patients under 10 years of age. 

The findings indicated continuous progress in reducing the overall burden of appendicitis globally. However, geographical variations in incidence and mortality rates indicate differences in access to health care. 

Full disclosures can be found in the published study.