Turkiye Klinikleri Journal of Medical Sciences

.: ORIGINAL RESEARCH
Seasonal Changes in the Incidence of Appendicitis in Diyarbakır, Turkey: Retrospective Study
Diyarbakır, Türkiye'de Apandisit İnsidansında Mevsimsel Değişiklikler: Retrospektif Çalışma
Ebral YİĞİTa, Yasemin DEMİR YİĞİTb
aClinic of General Surgery, Gazi Yaşargil Training and Research Hospital, Diyarbakır, TURKEY
bClinic of Pediatrics, Gazi Yaşargil Training and Research Hospital, Diyarbakır, TURKEY
Turkiye Klinikleri J Med Sci. 2021;41(4):377-83
doi: 10.5336/medsci.2021-84825
Article Language: EN
Full Text
ABSTRACT
Objective: The most common cause of acute abdomen requiring surgical intervention worldwide is appendicitis (AP). This study aimed to investigate the relationship between seasonal changes and the incidence of AP in Diyarbakır. Material and Methods: Patients who underwent an appendectomy with an AP diagnosis between January 1, 2016 and December 31, 2019 were evaluated retrospectively. The patients were divided into the following three groups on the basis of the general surgeons' findings during AP surgery: Group 1, acute appendicitis (AA); Group 2, plastron appendicitis (PLA); and Group 3, perforated appendicitis (PA). The patients were evaluated in terms of age, gender, and season of the year. Results: A total of 1,937 patients who participated in the study were divided into three groups: Group 1 (n=1,828), Group 2 (n=24), and Group 3 (n=85). AA was diagnosed most frequently in summer (28.1%). PLA (1.2%) and PA (4.4%) were diagnosed most frequently in fall (1.2%). The seasonal evaluation indicated that the number of patients was significantly higher in summer than in the other seasons (p=0.049). Conclusion: Seasonal changes were observed in the frequency of AP diagnoses. The incidence of AA increased in parallel with the increase in air temperature in the city. It was highest in summer.

Keywords: Appendicitis; age; gender; seasonal distribution
ÖZET
Amaç: Dünyada cerrahi müdahale gerektiren akut karının en sık nedeni apandisittir (AP). Bu çalışma, Diyarbakır ilinde mevsimsel değişiklikler ile AP insidansı arasındaki ilişkiyi araştırmayı amaçlamıştır. Gereç ve Yöntemler: 1 Ocak 2016-31 Aralık 2019 tarihleri arasında AP tanısı ile apendektomi yapılan hastalar geriye dönük olarak değerlendirildi. AP cerrahisi sırasında genel cerrahın bulgularına göre hastalar 3 gruba ayrıldı: Grup 1 akut apandisit (AA); Grup 2 plastron apandisit (PLA) ve Grup 3 perfore apandisit (PA). Hastalar; yaş, cinsiyet ve mevsimsel olarak değerlendirildi. Bulgular: Çalışmaya katılan 1.937 hasta Grup 1 (n=1.828), Grup 2 (n=24) ve Grup 3 (n=85) olmak üzere 3 gruba ayrıldı. AA en sık yaz aylarında (%28,1) teşhis edildi. PLA (%1,2) ve PA (%4,4) en sık sonbaharda (%1,2) teşhis edildi. Mevsimsel değerlendirme yaz mevsiminde hasta sayısının diğer mevsimlere göre anlamlı derecede yüksek olduğunu göstermiştir (p=0,049). Sonuç: AP tanı sıklığında mevsimsel değişiklikler gözlendi. AA insidansı kentte hava sıcaklığının artışına paralel olarak arttı. Yaz aylarında en yüksek oldu.

Anahtar Kelimeler: Apandisit; yaş; cinsiyet; mevsimsel dağılım
REFERENCES:
  1. Turner JR. The gastrointestinal tract. In: Kumar V, Abbas A, Aster JC, Fausto N, eds. Robbins and Cotran Pathologic Basis of Disease. 8th ed. Philadelphia: Saunders; 2010. p.870-1. [Link] 
  2. Karanikolić A, Karanikolić V, Djordjević L, Pe?ić I. Correlation between the season, temperature and atmospheric pressure with incidence and pathogenesis of acute appendicitis. Srp Arh Celok Lek. 2016;144(7-8):402-7. [Crossref] [PubMed] 
  3. Alegbeleye BJ, Adisa CA, Keskin H. Epidemiologic features of acute appendicitis in a tropical African population. WW Med. 2019;1(6): 202-11. [Link] 
  4. Arslan S, Aydogdu B, Arslan MS, Zeytun H, Okur MH, Basuguy E, et al. Analysis of risk factors for appendicitis in children: a multicenter epidemiological study. Dicle Med J. 2016;43(4):556-60. [Link] 
  5. Gao X, Colicino E, Shen J, Kioumourtzoglou MA, Just AC, Nwanaji-Enwerem JC, et al. Impacts of air pollution, temperature, and relative humidity on leukocyte distribution: an epigenetic perspective. Environ Int. 2019;126:395-405. [Crossref] [PubMed] [PMC] 
  6. Sulu B, Günerhan Y, Palanci Y, Işler B, Cağlayan K. Epidemiological and demographic features of appendicitis and influences of several environmental factors. Ulus Travma Acil Cerrahi Derg. 2010;16(1):38-42. [PubMed] 
  7. Sato Y, Kojimahara N, Kiyohara K, Endo M, Yamaguchi N; Appendicitis study group of Mobi-kids Japan. Association between climatic elements and acute appendicitis in Japan. J Surg Res. 2017;211:64-9. [Crossref] [PubMed] 
  8. WorldData.info [Internet]. © WorldData.info. Climate of Diyarbakır (Turkey). (Erişim tarihi: 10.05.2021). Available from: [Link] 
  9. Al-Omran M, Mamdani M, McLeod RS. Epidemiologic features of acute appendicitis in Ontario, Canada. Can J Surg. 2003;46(4):263-8. [PubMed] [PMC] 
  10. Uludağ Ö, Çağ S, Sabancı Ü, Kuşderci H, Abdullayev R. Apandisitin mevsimsel dağılımı [The seasonal distribution of appendicitis]. Sakarya Med J. 2016;6(3):120-3. [Crossref] 
  11. Bulut T, Arduçoğlu Merter A. İki bin üç yüz yetmiş altı apendektomi materyalinin retrospektif analizi [The retrospective analysis of 2376 appendectomy specimens]. F.Ü. Med J Health Sci. 2017;31(3):105-9. [Link] 
  12. Hanson KA, Jacob D, Alhaj Saleh A, Dissanaike S. In-hospital perforation risk in acute appendicitis: age matters. Am J Surg. 2020; 219(1):65-70. [Crossref] [PubMed] 
  13. Luckmann R, Davis P. The epidemiology of acute appendicitis in California: racial, gender, and seasonal variation. Epidemiology. 1991; 2(5):323-30. [Crossref] [PubMed] 
  14. Körner H, Söndenaa K, Söreide JA, Andersen E, Nysted A, Lende TH, et al. Incidence of acute nonperforated and perforated appendicitis: age-specific and sex-specific analysis. World J Surg. 1997;21(3):313-7. [Crossref] [PubMed] 
  15. Ahmed W, Akhtar MS, Khan S. Seasonal variation of acute appendicitis. Pak J Med Sci. 2018;34(3):564-7. [Crossref] [PubMed] [PMC] 
  16. Ilves I, Paajanen HE, Herzig KH, Fagerström A, Miettinen PJ. Changing incidence of acute appendicitis and nonspecific abdominal pain between 1987 and 2007 in Finland. World J Surg. 2011;35(4):731-8. [Crossref] [PubMed] 
  17. Stein GY, Rath-Wolfson L, Zeidman A, Atar E, Marcus O, Joubran S, et al. Sex differences in the epidemiology, seasonal variation, and trends in the management of patients with acute appendicitis. Langenbecks Arch Surg. 2012;397(7):1087-92. [Crossref] [PubMed] 
  18. Fares A. Summer appendicitis. Ann Med Health Sci Res. 2014;4(1):18-21. [Crossref] [PubMed] [PMC] 
  19. Gök M, Topal U, Öz AB, Akyüz M, Dal F, İslam DG, et al. Seasonal pattern of acute appendicitis in central anatolia. Erciyes Med J. 2020;42(2):207-12. [Link] 
  20. Göç İzleme Derneği. 2015-2020 dönemi sokağa çıkma yasakları; veri derleme ve medya izleme raporu. İstanbul: TMM Ajans Reklam Matbaa; 2020. [Link] 
  21. Jangra B, Jangra MS, Rattan KN, Kadian YS. Seasonal and day of week variations in acute appendicitis in north Indian children. J Indian Assoc Pediatr Surg. 2013;18(1):42-3. [Crossref] [PubMed] [PMC] 
  22. Lin KB, Lai KR, Yang NP, Chan CL, Liu YH, Pan RH, et al. Epidemiology and socioeconomic features of appendicitis in Taiwan: a 12-year population-based study. World J Emerg Surg. 2015;10:42. [Crossref] [PubMed] [PMC] 
  23. Akbulut S, Şener Bahçe Z, Öztaş T, Gümüş S, Söğütçü N, Sakarya H, et al. Assessment of demographic, clinical and histopathological features of patients who underwent appendectomy due to a presumed diagnosis of acute appendicitis. Ulus Travma Acil Cerrahi Derg. 2021;27(3):315-24. [Link] 
  24. Brumer M. Appendicitis. Seasonal incidence and postoperative wound infection. Br J Surg. 1970;57(2):93-9. [Crossref] [PubMed] 
  25. Nabi B. Acute diarrhea control in primary care. [Erişim tarihi: 05.10.2016]. Erişim linki: [Link] 
  26. Naumova EN. Mystery of seasonality: getting the rhythm of nature. J Public Health Policy. 2006;27(1):2-12. [Crossref] [PubMed] [PMC] 
  27. Anderson JE, Bickler SW, Chang DC, Talamini MA. Examining a common disease with unknown etiology: trends in epidemiology and surgical management of appendicitis in California, 1995-2009. World J Surg. 2012;36(12): 2787-94. [Crossref] [PubMed] 
  28. Fletcher SM, McLaws ML, Ellis JT. Prevalence of gastrointestinal pathogens in developed and developing countries: systematic review and meta-analysis. J Public Health Res. 2013; 2(1):42-53. [Crossref] [PubMed] [PMC] 
  29. Petroianu A, Oliveira-Neto JE, Alberti LR. Incidência comparativa da apendicite aguda em população miscigenada, de acordo com a cor da pele [Comparative incidence of acute appendicitis in a mixed population, related to skin color]. Arq Gastroenterol. 2004;41(1):24-6. [Crossref] [PubMed] 

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