Apendicitis aguda complicada en el anciano. Factores predisponentes. Utilidad de las escalas de probabilidad diagnóstica y tratamiento más adecuado

espanolINTRODUCCION. La apendicitis aguda (AA) tradicionalmente se ha considerado una patologia de gente joven. Con el envejeci-miento progresivo de la poblacion, aparece mas frecuentemente a partir de los 65 anos. El diagnostico precoz y el tratamiento minimamente invasivo evitarian una elevada morbi-mortalidad en estos pacientes. MATERIAL Y METODOS.Se realizo un estudio retrospectivo de las apendicectomias realizadas en un Hospital de Nivel 1 durante 2010-2016. Se seleccionaron los pacientes con edad mayor o igual a 65 anos. Se efectuo un analisis descriptivo de la cohorte y despues un analisis univariante, comparando AA complicada (plastron, gangrenosa, perforada) frente a AA no complicada. Con las variables estadisticamente significativas (p18mg/ml [OR=14,35(1,49–141,52)] y Leucocitos>10.000/mL [OR=11,70(1,15–119,26)]. CONCLUSIONES.La apendicitis aguda es una entidad cada vez mas frecuente en ancianos. Las escalas de probabilidad diagnostica no son buenos predictores en ancianos. La PCR>18 mg/ml y los Leucocitos>10.000/mL demostraron ser factores predictores independientes para AA complicada. La apendicectomia laparoscopica se consolida como un tratamiento idoneo, seguro y con buenos resultados tambien en ancianos. EnglishINTRODUCTION.Acute appendicitis (AA) has traditionally been considered a pathology of young people. With the progressive aging of the population, it appears more frequently after 65 years of age. Early diagnosis and minimally invasive treatment would avoid a high morbidity and mortality in these patients. MATERIAL AND METHODS. A retrospective study of appendectomies performed in a Level 1 Hospital during 2010-2016 was conducted. Patients older than or equal to 65 years were selected. A descriptive analysis of the cohort was made and then a univariate analysis, comparing complicated AA (plastron, gangrenous, perforated) versus uncomplicated AA. With the statistically significant variables (p 18mg / ml [OR = 14.35 (1.49-141.52)] and Leukocytes > 10,000 / (L [OR = 11.70 (1.15-119, 26)]. CONCLUSIONS. Acute appendicitis is an increasingly common entity in the elderly. Diagnostic probability scales are not good predictors in the elderly. CRP> 18 mg / ml and Leukocytes> 10,000 / μL proved to be independent predictors for complicated AA. Laparoscopic appendectomy is consolidated as a suitable, safe treatment with good results also in the elderly.