Seasonal and climatic variation in the incidence of adult acute appendicitis: a seven year longitudinal analysis

Abstract

Abstract Background Acute appendicitis represents an extremely common surgical emergency, yet its aetiology remains uncertain. A multifactorial understanding of its causation has emerged along with increasing evidence of seasonal variation. This study seeks to find evidence for such a circannual trend within the United Kingdom (UK), and further assess key meteorological indicators which may be causative of any such variation. Methods The patient records of a region health body in the North East of England were retrospectively assessed over a 7-year period. The incident cases of acute appendicitis were recorded and averaged by month before undergoing statistical analysis for variation and correlation with average temperature, sunlight hours, and rainfall. Results The incidence of acute appendicitis revealed significant seasonal variation with only 38 incident cases in the months of January compared to 73 in July, a 92.1% increase. Only a weak correlation was seen between incidence and average sunlight hours/rainfall, however a significant, positive correlation was found between incidence and average temperature (r = 0.58, p = 0.048). Conclusion Compelling evidence is found to support the existence of a circannual trend for acute appendicitis. Data suggests a seasonal peak in the month of July, accompanied by a low in January, a finding that develops the understanding of this trend from previously equivocal research in the UK. A clear correlation is also established between the incidence of acute appendicitis and average temperature. The 92.1% increase between the coolest and warmest months suggests a greater magnitude for this as a risk factor than has previously been shown.