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
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