C. Hannigan1, A. Pamula1, A. Huddock1, P. Faughnan2, H. Norman1, J. Granet1, R. Behm1 1Guthrie Clinic,Trauma & Surgical Critical Care,Sayre, PA, USA 2University Of Virginia,Charlottesville, VA, USA
Introduction: Appendectomy is the most common operation performed by the trauma surgeons at our rural level II trauma center. Despite advances in medicine transforming this once life-threatening pathology into an outpatient operation, our aging and obese population can suffer severe complications from acute appendicitis. Seasonal patterns of appendicitis have been reported with a peak seen in the summer months. Without a clear reason for this pattern, some have suggested environmental influences such as air pollution or pollen as causes whereas others postulate dietary changes as the culprit. We feel the body’s immune response to seasonal allergies may be associated with appendicitis and hypothesize there is a correlation between appendicitis and seasonal pollen counts.
Methods: We retrospectively captured all patients in our healthcare network who underwent an appendectomy as the primary diagnosis from 2009-2018 and subdivided this data into monthly categories. We then sought to quantify the monthly pollen count in our region. Accessing The Weather Channel website, we were able to obtain the previous year’s monthly pollen counts in our county. This data was represented by a 6-point scale that we used to determine each month’s pollen count. We compared the trends in appendectomy rates to the monthly pollen counts. A T-test was used to analyze trends in appendectomy rates.
Results: A total 1,344 appendectomies were performed during this time period. 740 appendectomies were performed during the warmer months of April-Sept which was significantly more than the 604 appendectomies performed in the cooler months of Oct-March (p<0.01). Figure 1 shows the trend in number of appendectomies performed throughout the year and how it seems to mirror the pollen count. The only trend that doesn’t seem to correlate to the pollen count is the rise in appendectomies from Nov to Dec, but this rise was not significant (p=0.273).
Conclusion: Our results affirm previous reports linking warmer weather with appendicitis. We were surprised to see a decrease in appendectomy rates in the warmest month of July however when compared to pollen counts, it seemed to correlate. We feel these results strengthen the previous theories relating pollen to appendicitis. Further study is warranted because confirming this relationship may have potential clinical benefit. Patients who are elderly, immunocompromised, morbidly obese, cardiopulmonary cripples or have a hostile abdomen who also have seasonal allergies may be considered for aggressive medical management of their allergies. By decreasing the inflammatory response to seasonal allergies, we may be able to reduce these high-risk patients’ incidence of appendicitis.
