Abstract
BACKGROUND AND AIM: Currently, there is a lack of attention and research on appendicitis in the elderly population. In light of this, this study aims to comprehensively assess the burden of appendicitis in individuals aged 60 and above based on the 2021 Global Burden of Disease data, in order to provide a basis for formulating corresponding prevention and control strategies for elderly appendicitis. METHODS: This study utilized the Global Burden of Disease (GBD) database to conduct a quantitative analysis of the burden of appendicitis among individuals aged 60 and above from 1990 to 2021, encompassing prevalence, incidence, disability-adjusted life years (DALYs), mortality, and their age-standardized rates (ASR). Additionally, through the Age-Period-Cohort (APC) model, we conducted an in-depth analysis of the impact of age, period, and cohort factors on the disease. Meanwhile, this study also conducted decomposition analysis, frontier analysis, and health inequality assessment, meticulously evaluating the influencing factors and disease disparities. Ultimately, the Bayesian Age-Period-Cohort (BAPC) model was employed to predict the burden up to the year 2050. RESULTS: From 1990 to 2021, the ASR of prevalence and incidence showed a slight increase, with the ASR of prevalence and incidence in females being higher than that in males. Meanwhile, during the same period, the ASR of DALYs and mortality rates significantly decreased, and the ASR of DALYs and mortality rates in males were higher than those in females. Decomposition analysis revealed that population growth is the dominant factor driving the increase in the global burden of appendicitis in the elderly. Over time, the inequality in DALYs associated with appendicitis in the elderly has significantly decreased in relation to SDI. Frontier analysis has also identified several countries with significant potential in reducing the burden of appendicitis. APC analysis indicates that the global mortality rate of appendicitis in the elderly tends to increase with age, but this trend varies between different genders. Predictions indicate that by 2050, the global ASR will show a declining trend, with a more pronounced decrease among females. CONCLUSION: Elderly appendicitis exhibits significant variations across gender, age groups, regions, and countries. Our analytical findings provide valuable epidemiological data for health policymakers, while highlighting the urgency and necessity of enhancing precise diagnosis and optimizing treatment protocols for this vulnerable elderly population.