J Korean Soc Emerg Med.  2010 Oct;21(5):600-605.

A Clinical Study of Acute Appendicitis in Schizophrenia Patients Presenting at an Emergency Center

• Han KH
• Yang JI
• Cho SU
• You YH
• Yoo IS
• Lee BK
• Lee JY
• Jeong WJ
• Park JS
• Lee WS

Abstract

PURPOSE
To investigate the clinical characteristics and Alvarado scores of schizophrenia with patients acute appendicitis presenting at the emergency department.
METHODS
We retrospectively reviewed medical records and identified schizophrenia patients who were diagnosed with acute appendicitis between January 2000 to December 2009 and who presented at the emergency department in 6 University hospitals. Comparisons were made with non-schizophrenic patients with acute appendicitis. Data collected included the patient's age, sex, clinical features, time interval between onset of symptoms and visiting the hospital, Alvarado score, disease complications, and diagnostic imaging modality.
RESULTS
We identified 27 schizophrenia patients with acute appendicitis. Mean age was 34.5+/-8.3; 51.9% were women. The median time from onset of symptoms to visiting the emergency department was 3.8+/-1.4 days in the schizophrenic group and 2.3+/-2.1 in the normal control group. The mean Alvarado scores were 5.4+/-1.5 for the schizophrenic group and 6.5+/-2.1 for controls. Perforation of the appendix and formation of abscesses was higher in schizophrenic patients with appendicitis.
CONCLUSION
These findings suggest that acute appendicitis is diagnosed late and with difficulty in schizophrenic patients and these patients may be the most vulnerable to failure to obtain timely surgical care. Early and careful access is recommended in suspected cases of appendicitis in schizophrenia patients.

Keyword

Appendicitis; Schizophrenia; Hospital emergency service

MeSH Terms

Abscess
Appendicitis
Appendix
Diagnostic Imaging
Emergencies
Emergency Service, Hospital
Female
Hospitals, University
Humans
Medical Records
Retrospective Studies
Schizophrenia