Fransvea P, Chiarello MM, Fico V, Cariati M, Brisinda G. Influence of sarcopenia and frailty in the management of elderly patients with acute appendicitis. World J Clin Cases 2024; 12(33): 6580-6586 [DOI: 10.12998/wjcc.v12.i33.6580]
Corresponding Author of This Article
Giuseppe Brisinda, MD, Professor, Surgeon, Emergency and Trauma Surgery Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, No. 8 Largo Agostino Gemelli, Roma 00168, Italy. gbrisin@tin.it
Research Domain of This Article
Surgery
Article-Type of This Article
Editorial
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Nov 26, 2024; 12(33): 6580-6586 Published online Nov 26, 2024. doi: 10.12998/wjcc.v12.i33.6580
Influence of sarcopenia and frailty in the management of elderly patients with acute appendicitis
Pietro Fransvea, Maria Michela Chiarello, Valeria Fico, Maria Cariati, Giuseppe Brisinda
Pietro Fransvea, Valeria Fico, Giuseppe Brisinda, Emergency and Trauma Surgery Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Roma 00168, Italy
Maria Michela Chiarello, Department of Surgery, Provincial Health Authority, Cosenza 87100, Italy
Maria Cariati, Department of Surgery, Provincial Health Authority, Crotone 88900, Italy
Giuseppe Brisinda, Translational Medicine and Surgery, Catholic School of Medicine, Roma 00168, Italy
Co-first authors: Pietro Fransvea and Maria Michela Chiarello.
Author contributions: Fransvea P, Chiarello MM and Brisinda G designed the research; Fransvea P, Fico V and Cariati M performed the research; Fransvea P and Fico V analyzed the data. All authors wrote and approved the final manuscript.
Conflict-of-interest statement: Dr. Brisinda has nothing to disclose.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Giuseppe Brisinda, MD, Professor, Surgeon, Emergency and Trauma Surgery Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, No. 8 Largo Agostino Gemelli, Roma 00168, Italy. gbrisin@tin.it
Received: March 14, 2024 Revised: August 6, 2024 Accepted: August 14, 2024 Published online: November 26, 2024 Processing time: 196 Days and 17.4 Hours
Abstract
In developed countries, the average life expectancy has been increasing and is now well over 80 years. Increased life expectancy is associated with an increased number of emergency surgical procedures performed in later age groups. Acute appendicitis is one of the most common surgical diseases, with a lifetime risk of 8%. A growing incidence of acute appendicitis has been registered in the elderly population and in the oldest groups (> 80 years). Among patients > 50-year-old who present to the emergency department for acute abdominal pain, 15% have acute appendicitis. In these patients, emergency surgery for acute appendicitis is challenging, and some important aspects must be considered. In the elderly, surgical treatment outcomes are influenced by sarcopenia. Sarcopenia must be considered a precursor of frailty, a risk factor for physical function decline. Sarcopenia has a negative impact on both elective and emergency surgery regarding mortality and morbidity. Aside from morbidity and mortality, the most crucial outcomes for older patients requiring emergency surgery are reduction in function decline and preoperative physical function maintenance. Therefore, prediction of function decline is critical. In emergency surgery, preoperative interventions are difficult to implement because of the narrow time window before surgery. In this editorial, we highlight the unique aspects of acute appendicitis in elderly patients and the influence of sarcopenia and frailty on the results of surgical treatment.
Core Tip: The global proportion of older subjects is steadily increasing. This is associated with an increased number of emergency surgical procedures performed in this age group. Acute appendicitis is one of the most common surgical diseases, with a lifetime risk of 8%. A growing incidence of acute appendicitis has been registered in the elderly population and in the oldest age group (> 80 years). In this editorial, we highlight the characteristics of acute appendicitis in elderly patient and the influence of sarcopenia and frailty on the results of surgical treatment.
