{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T06:06:34Z","timestamp":1789020394230,"version":"build-2803163510"},"reference-count":23,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T00:00:00Z","timestamp":1788825600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T00:00:00Z","timestamp":1788998400000},"content-version":"vor","delay-in-days":2,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Universit\u00e4tsklinikum W\u00fcrzburg"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Langenbecks Arch Surg"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Acute appendicitis is a common indication for emergency abdominal surgery. Octogenarians (\u2265\u200980 years) are considered high risk due to comorbidities and reduced physiological reserve. This study examined age-related differences in symptoms, surgical management, and outcomes in patients undergoing surgery for acute appendicitis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This multicenter retrospective cohort study includes 1,582 surgically treated patients from 41 German hospitals, comprising 1,533 non-octogenarians (18\u201379 years) and 49 octogenarians (\u2265\u200980 years).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Octogenarians had higher comorbidity burden and ASA classification (both\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Clinical presentation was largely comparable; however, octogenarians experienced lower pain intensity (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.05) and had higher CRP levels (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Complicated appendicitis was more prevalent in octogenarians (63.3% vs. 28.1%;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), with higher rates of perforation, peritonitis, and abscess formation (all\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Consequently, extended resections (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.01), open or converted surgery (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), drainage (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), and stoma formation (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.01) were more common. Postoperative complications (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), mortality (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.002), ICU admission (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), duration of antimicrobial therapy (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), and hospital stay (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) were all increased. Following propensity score matching, outcomes were largely comparable between octogenarians and younger patients, indicating the comorbidity spectrum of the elderly, rather than chronological age alone, as key determinants.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Despite a similar initial presentation, octogenarians present with more advanced appendicitis and significantly worse postoperative outcomes. This emphasizes the need for age- and comorbidity-adapted diagnostic and perioperative strategies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00423-026-04202-3","type":"journal-article","created":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T19:33:50Z","timestamp":1788896030000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Does age matter? 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In addition, several participating centers obtained approval from their responsible local review boards in accordance with local requirements. The study was conducted in accordance with the ethical standards of the institutional and\/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.","order":1,"name":"Ethics","label":"Ethical approval and consent to participate","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"According to the responsible ethics committees, there is no need for informed consent due to the retrospective anonymous character of the study, which is isolated based on existing hospital documentation systems and without the need for further data acquisition or any study-related contact to the patient.","order":2,"name":"Ethics","label":"Consent for publication","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":3,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Declarations"}}],"article-number":"230"}}