Temporal Analysis of Nationwide Emergency Department Utilization and Appendectomy Trends
by
, and
Ali A. Aalam
1
,
Nofel Iftikhar
2,
Hoor ul Ain
3,
Fahama Batool
4,
William Mulkerin
5,
Tyler J. Loftus
6 and
Catherine W. Striley
1,* 1
Department of Epidemiology, College of Public Health and Human Profession & College of Medicine, University of Florida, Gainesville, FL 32608, USA
2
Department of Biology, College of Liberal Arts and Sciences, University of Florida, Gainesville, FL 32608, USA
3
College of Medicine, King Edward Medical University, Lahore 54000, Pakistan
4
Al Nafees Medical College, Isra University, Islamabad 44000, Pakistan
5
Department of Emergency Medicine, School of Medicine, Stanford University, Stanford, CA 94035, USA
6
Division of Acute Care Surgery, Department of Surgery, University of Florida, Gainesville, FL 32608, USA
*
Author to whom correspondence should be addressed.
Emerg. Care Med. 2025, 2(2), 22; https://doi.org/10.3390/ecm2020022
Submission received: 10 March 2025
/
Revised: 28 March 2025
/
Accepted: 7 April 2025
/
Published: 29 April 2025
Abstract
:Background/Objectives: This study examines trends in appendectomy utilization in US emergency departments (EDs) from 2012 to 2021 using National Emergency Department Sample (NEDS) data. The objective is to explore appendectomy frequency, appendicitis management, disease progression, and resource distribution in EDs. A predictive model was developed to forecast trends from 2022 to 2032, aiming to improve patient outcomes and support operational planning in EDs. Methods: A cross-sectional analysis was conducted using NEDS data from 2012 to 2021. Appendectomy trends were assessed in four ways: first, comparing the total number of appendectomies with total ED visits to determine relative frequencies; second, comparing trends in Complicated Appendicitis (CA) and Uncomplicated Appendicitis (UA) patients; third, categorizing each appendicitis type based on clinical complications and comorbidities; and finally, using a linear regression model to predict trends through 2032. Results: During the study period, the overall appendectomy rate decreased, while the proportion of patients with Complicated Appendicitis rose. Appendectomies in patients without complications or comorbidities showed a decline, while those in patients with complications or comorbidities increased. Predictive modeling suggests that trends in all subgroups will continue to rise until 2032. Conclusions: This study highlights evolving appendicitis management trends in EDs. The results advocate for fast-track appendectomy pathways and better resource allocation to enhance efficiency, reduce complications, and improve patient care. These findings assist healthcare systems in preparing for ED throughput challenges and refining surgical management strategies.
1. Introduction
Appendectomy rates in the United States have fluctuated over the past decade, reflecting changes in diagnostic practices, evolving treatment paradigms, and shifts in emergency department (ED) utilization [1,2,3]. While the overall incidence of appendectomy has declined, the proportion of complicated cases requiring surgical intervention has increased, highlighting potential delays in diagnosis or evolving management strategies [4,5,6]. Prior research has documented trends in acute appendicitis, but there remains a critical gap in understanding the specific patterns of appendectomy utilization within ED settings [7].
Given the increasing emphasis on predictive analytics in emergency care, examining temporal trends in appendectomy can provide valuable insights for healthcare planning [8,9,10]. Identifying variations in procedural rates and patient demographics can inform resource allocation, optimize surgical preparedness, and enhance clinical decision-making [11]. This study leverages data from the National Emergency Department Sample (NEDS) from 2012 to 2021 to analyze appendectomy trends, with predictive modeling extending forecasts through 2032 [12,13,14]. By characterizing these patterns, we aim to equip hospitals and policymakers with data-driven strategies to anticipate surgical demand and refine treatment protocols for acute appendicitis [15,16,17].
2. Materials and Methods
The study employed a cross-sectional temporal analysis using data from the Nationwide Emergency Department Sample (NEDS), encompassing 1.3 billion ED visits from 2012 to 2021 across 42 states and the District of Columbia. It examined longitudinal trends in appendectomies performed in the ED and used predictive linear regression to estimate future trends for each appendectomy subgroup from 2022 to 2032. Inclusion criteria encompassed patients presenting to the ED with a diagnosis of appendicitis, identified using relevant ICD-9-CM (540–543) and ICD-10-CM (K352–K38) codes.
This criterion captured two primary groups: patients with Complicated Appendicitis and those with Uncomplicated Appendicitis. Patients with Complicated Appendicitis had associated complications, including generalized or localized peritonitis. In contrast, the Uncomplicated Appendicitis group included cases such as unspecified acute appendicitis, acute appendicitis without perforation, appendicitis with/without gangrene, hyperplasia of the appendix, appendicular concretions, or fistula of the appendix. Both groups were further stratified based on the presence or absence of complications (e.g., perforation, abscess) and clinical comorbidities involving major organ systems (cardiovascular, respiratory, neurological, renal, musculoskeletal, or endocrinological).
Utilizing NEDS, the largest all-payer ED database in the U.S., a cross-sectional analysis was conducted to evaluate trends in appendectomy rates from 2012 to 2021. Total ED visits were used as a denominator to calculate relative frequencies of appendectomies over time, allowing for standardization across fluctuating ED visit volumes. However, recognizing that ED visit trends—especially during the COVID-19 era—could introduce biases, additional subgroup analyses independent of total ED volume were performed. Appendectomy rates were stratified into two main groups: appendectomies in patients with Complicated Appendicitis (AC) and appendectomies in patients with Uncomplicated Appendicitis (ac). Relative percentage comparisons were conducted alongside odds ratio calculations to assess the likelihood of undergoing appendectomy in complicated versus uncomplicated cases.
To enhance granularity, further stratification was performed within each appendicitis type, dividing cases into three subgroups: Complicated Appendicitis patients with Major Clinical Complication (AMCC), Complicated Appendicitis patients with Comorbidity in the ED (ACC), Complicated Appendicitis without Complication or Comorbidity in the ED (AWC), Uncomplicated Appendicitis patients with Major Clinical Complication (amcc), Uncomplicated Appendicitis patients with Clinical Comorbidity in the ED (acc), and Uncomplicated Appendicitis patients without Major Clinical Complication or Comorbidity in the ED (awc). The annual frequency of each subgroup was measured relative to total appendectomies performed that year, and comparative analyses were conducted using these standardized rates.
A predictive model was developed using linear regression to forecast appendectomy trends from 2022 to 2032. A linear approach was selected due to the consistent historical trajectory of appendectomy rates, making it suitable for extrapolation. Key predictor variables included year, appendicitis type (complicated vs. uncomplicated), comorbidity status, and presence of major clinical complications. Variable selection was based on iterative assessments of historical data trends, ensuring model parsimony while maintaining predictive robustness. Sensitivity analyses were conducted to evaluate the stability of projections, and alternative models (e.g., polynomial regression) were tested but did not offer substantial improvements in predictive accuracy. This structured approach ensures that observed trends are contextualized appropriately and that the predictive model is rigorously justified for forecasting appendectomy trends.
3. Results
First, analyzing the general trend of total appendectomies relative to total ED visits, a clear downward trajectory was observed. The relative rate of appendectomies peaked in 2013 (0.029%), decreased in 2014 (0.027%), and dropped sharply in 2015 (0.006%). Following this anomaly, the trend returned to more stable values in 2016 (0.022%) and continued a gradual decline, reaching its lowest point in 2021 (0.018%). Although these relative percentages represent small values, they indicate a sustained reduction in appendectomies performed relative to ED visits. The yearly breakdown of total ED visits, appendectomies performed, and their percentages is detailed in Table 1.
Analysis of appendectomies by appendicitis type showed a shift over time. Appendectomies in patients with Complicated Appendicitis (AC) increased in relative frequency, peaking in 2017 (45%) before stabilizing at 39% in 2021. Conversely, appendectomies in patients with Uncomplicated Appendicitis (ac) exhibited an opposite trend, declining from 74% in 2012 to 55% in 2017 before rebounding to 61% in 2021. The calculated odds ratio for undergoing an appendectomy due to Complicated Appendicitis relative to Uncomplicated Appendicitis followed a unimodal distribution, rising from 0.12 in 2012 to a peak of 0.67 in 2017 before settling at 0.41 in 2021. These findings are summarized in Table 2.
Although analyzing the trends of total appendectomies, AC, and ac provides a broad understanding of appendectomy trends. To further the analysis, appendectomies in ED were divided into six subgroups, each of which were compared relative to total appendectomies, yielding a percentage, and analyzed on a year-after-year basis. The six subgroups were defined as AMCC, ACC, AWC, amcc, acc and awc.
Among the six subgroups, appendectomies in patients with Uncomplicated Appendicitis without comorbidities or complications (awc) were the most prevalent but exhibited an overall declining trend. In 2012, awc cases constituted the majority of ED appendectomies performed (64.1%); however, this proportion decreased to 43.15% by 2021. The frequency of awc cases consistently declined from 2012 to 2017, experienced a slight uptick in 2018 and 2019, and resumed a downward trend through 2020 and 2021.
Appendectomies in patients with Complicated Appendicitis but without complications or comorbidities (AWC), the second most prevalent group, exhibited a unimodal trend, starting at a relatively low of 17% in 2012, peaking at 28.4% in 2018, and declining steadily to 22.2% by the end of the study period in 2021.
Appendectomies performed in Uncomplicated Appendicitis patients with Clinical Comorbidity in the ED (acc) showed modest growth from 2012, starting at 8.4%, to 2017, where it reached 9.2%, fluctuating by less than 1 percent over the five-year period. After 2017, the relative frequency increased more consistently, peaking at 13.9% in 2021, the final year of the study.
Appendectomies performed on patients with Complicated Appendicitis and Clinical Comorbidity in the ED (ACC) followed an increasing trend, with a low in 2012 (7.4%) and consistent growth until 2018 (13.2%). A slight drop was observed in 2019 (12.1%), followed by an immediate uptick in 2020, reaching its peak (14.1%), and finally declining slightly in 2021 (13.6%).
The relative frequency of Appendectomies performed in Uncomplicated Appendicitis patients with Major Clinical Complication (amcc) in the ED exhibited a consistent increase over the study period, starting at 1.56% in 2012 and rising steadily to 4.03% in 2021.
Appendectomies performed in Complicated Appendicitis patients with Major Clinical Complication (AMCC) followed a similar trend with some minor variation seen towards the tail end of the study period. Beginning with the lowest calculated value in 2012 (1.6%), constant growth was observed until 2017 (2.7%), where a slight dip was noticed into 2018 (2.3%) and subsequently, into 2019 (1.92%). Following 2019, constant growth was reflected by the calculated values of 2020 (2.8%) and 2021, containing the highest relative value (3.1%).
Although only one subgroup, appendectomies in patients with Uncomplicated Appendicitis without comorbidities or complications (awc), showed a consistent decrease in relative frequency over the study period, this subgroup accounted for the majority of total appendectomies performed in the ED each year. Consequently, the observed decline in its frequency mirrored the overall decrease in appendectomy rates in the ED. Additionally, all subgroups experienced a numerical low in 2015, likely due to the transition from ICD-9 to ICD-10 coding for medical reporting [18,19,20,21,22,23,24]. The numerical values and relative percentages for each subgroup, calculated annually, are presented in Table 3.
Predictive modeling based on data from 2012 to 2021 projected a linear increase in all appendectomy subgroups from 2022 to 2032. However, despite a drop in appendectomy rates during 2019–2021, the model forecasts an overall upward trajectory, which may reflect population growth trends. Table 4 and Figure 1 present these projections.
4. Discussion
The observed decline in overall appendectomy rates aligns with evolving diagnostic and treatment practices. Advances in imaging technology, including implementing newer-generation CT scanners, have improved detection accuracy and increased differentiation between complicated and uncomplicated cases [25]. Additionally, the expanded use of non-contrast CT scans has facilitated more rapid decision-making. At the same time, a growing preference for non-surgical (antibiotic-based) management has likely contributed to fewer overall appendectomies [26,27,28,29,30].
The increase in the relative proportion of complicated appendicitis cases could stem from multiple factors, including improved imaging [31,32,33] leading to higher detection rates of small abscesses, changes in diagnostic criteria, and possible delays in hospital presentation due to healthcare access disparities or external factors such as the COVID-19 pandemic. Notably, the decrease in appendectomies during 2020–2021 coincides with COVID-19-related healthcare disruptions, raising the possibility that some cases of acute appendicitis went undiagnosed or were managed conservatively.
Appendicitis can be particularly difficult to diagnose, as presenting symptoms, which include loss of appetite, nausea, vomiting, swelling, and pain in the abdomen, can often be mistaken for other common gastrointestinal disorders, including but not limited to gastroenteritis, constipation, irritable bowel syndrome, or a urinary tract infection [34,35]. Appendicitis is often diagnosed out of an abundance of caution, as, if left untreated, persistent appendicitis can cause a burst appendix or peritonitis, both serious complications [36,37,38]. Accordingly, appendicitis is often wrongly diagnosed to mitigate potential complication risk, even if physicians are not absolute regarding the diagnosis [39]. Further perpetuating this phenomenon is the relatively routine nature of appendectomies, being one of the most regularly performed, well-studied, and least invasive surgical procedures, warranting little recovery time and almost no patient lifestyle changes [40].
Another key finding is the increased proportion of appendectomies performed in patients with comorbidities (ACC and acc). This trend is likely influenced by the rising prevalence of chronic conditions such as diabetes and cardiovascular disease [41,42], which can complicate both diagnosis and management of appendicitis [43,44]. Surgical complexity increases in these patients, potentially requiring more cautious management strategies and prolonged hospitalization.
Complications, as their name suggests, can complicate surgical interventions and adversely impact patient outcomes [45,46]. Managing multiple comorbidities simultaneously may challenge physicians, with some conditions requiring precedence over others. In appendectomy cases, certain complications—such as perforation, abscess formation, and septic shock—can disrupt standard surgical protocols and, in some cases, preclude surgical intervention altogether [47,48,49,50,51].
The rising frequencies of patients with Complicated Appendicitis and Appendicitis with Clinical Comorbidities represent worrying trends and the need for further public health education regarding the potential complications related to appendectomies [52]. Additionally, due to the decreasing rates of appendectomies, better resource allocation can be practiced. Consolidating and redirecting resources can help support other hospital and EDs [52]. More efficient resource management and personnel flow can help alleviate preexisting treatment issues in the ED such as overcrowding [52].
Limitations
This study has several limitations. First, it relies on administrative data from NEDS, which may be subject to coding errors and inconsistencies, particularly during the transition from ICD-9 to ICD-10 in 2015. Additionally, the dataset does not include granular clinical details such as laboratory findings, imaging results, or physician decision-making rationales, which could provide deeper insights into appendicitis management trends.
Second, the retrospective observational nature of this study limits causal inference. While trends in appendectomy rates suggest evolving diagnostic and treatment practices, confounding variables such as healthcare access disparities, regional practice differences, and variations in hospital policies may also influence the observed trends.
Third, the predictive modeling used in this study assumes a linear trajectory based on historical data. However, future trends may be influenced by factors not accounted for in the model, such as advancements in non-surgical management strategies, shifts in healthcare policies, or emerging infectious diseases that impact hospital utilization patterns. Sensitivity analyses excluding 2015 may help refine these projections, but more sophisticated time-series models should be explored in future research.
5. Conclusions
This study provides a comprehensive temporal analysis of appendectomy trends in U.S. emergency departments, demonstrating a general decline in appendectomy rates with an increasing proportion of complicated cases. Improved imaging, evolving treatment paradigms, and changes in healthcare utilization likely contribute to these shifts. The findings underscore the need for continued surveillance and adaptation of resource allocation strategies to optimize patient care and ED efficiency. Future research should further explore the impact of non-surgical management and healthcare access on appendicitis outcomes.
By addressing these considerations, this study contributes valuable insights into appendicitis management trends, aiding policymakers and healthcare providers in improving treatment protocols and patient care strategies.
Author Contributions
Conceptualization, A.A.A. and N.I.; methodology, A.A.A. and N.I.; software, A.A.A.; validation, C.W.S., W.M. and T.J.L.; formal analysis, A.A.A., N.I. and C.W.S.; investigation, A.A.A.; resources, A.A.A.; data curation, A.A.A.; writing—original draft preparation, A.A.A., N.I., H.u.A. and F.B.; writing—review and editing, T.J.L., W.M., H.u.A. and F.B.; visualization, A.A.A.; supervision, C.W.S. All authors have read and agreed to the published version of the manuscript.
Funding
This research received no external funding.
Institutional Review Board Statement
Ethical review and approval were waived for this study due to the utilization of deidentified data from NEDS.
Informed Consent Statement
Patient consent was waived due to no direct interaction with patients. This study utilizes the NEDS data which collect the information of deidentified patients annually in the form of surveys.
Data Availability Statement
NEDS data summaries are publicly available on the website: www.hcup-us.ahrq.gov/nedsoverview.jsp (accessed on 25 March 2025). However, NEDS HCUP Data Handling Training must be cleared before using these data for research purposes.
Conflicts of Interest
The authors declare no conflicts of interest.
Abbreviations
The following abbreviations are used in this manuscript:
| EDs | Emergency departments |
| AC | Appendectomies performed in patients with Complicated Appendectomies |
| ac | Appendectomies performed in patients with Uncomplicated Appendectomies |
| OR | Odds ratio comparing the odds of appendectomies in patients with Complicated Appendicitis to the odds of appendectomies in patients with Uncomplicated Appendicitis |
| AMCC | Appendectomies performed in Complicated Appendicitis patients with Major Clinical Complication |
| ACC | Appendectomies performed on patients with Complicated Appendicitis and Clinical Comorbidity |
| AWC | Appendectomies in patients with Complicated Appendicitis but without Complications or Comorbidities |
| amcc | Appendectomies performed in Uncomplicated Appendicitis patients with Major Clinical Complication |
| acc | Appendectomies performed in Uncomplicated Appendicitis patients with Clinical Comorbidity |
| awc | Appendectomies in patients with Uncomplicated Appendicitis without Comorbidities or Complications |
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Figure 1.
Line graph showing the number of appendectomies, in each of the six subgroups, during the initial study period, from 2012 to 2021, and the predictive period, from 2022 to 2032.
Figure 1.
Line graph showing the number of appendectomies, in each of the six subgroups, during the initial study period, from 2012 to 2021, and the predictive period, from 2022 to 2032.
Table 1.
Table showcasing total ED visits, total appendectomies performed in emergency setting, and percentage denoting total appendectomies performed in relation to total ED visits on an annual basis from 2012 to 2021 in 42 states of United States of America including District of Columbia.
Table 1.
Table showcasing total ED visits, total appendectomies performed in emergency setting, and percentage denoting total appendectomies performed in relation to total ED visits on an annual basis from 2012 to 2021 in 42 states of United States of America including District of Columbia.
| Year | Total ED Visits | Total Appendectomies N (%) |
|---|---|---|
| 2012 | 134,399,179 | 37,679 (0.0280%) |
| 2013 | 134,869,015 | 39,662 (0.0294%) |
| 2014 | 137,807,901 | 37,450 (0.0272%) |
| 2015 | 143,469,670 | 7896 (0.0055%) |
| 2016 | 144,842,742 | 32,516 (0.0224%) |
| 2017 | 144,814,803 | 29,354 (0.0203%) |
| 2018 | 143,454,430 | 32,668 (0.0228%) |
| 2019 | 143,432,284 | 27,365 (0.0191%) |
| 2020 | 123,278,165 | 25,175 (0.0204%) |
| 2021 | 126,968,321 | 23,106 (0.0182%) |
Table 2.
Representing total appendectomies performed, total APCAs performed with relative frequency, total APUCAs performed with relative frequency, and odds ratio calculated all on an annual basis.
Table 2.
Representing total appendectomies performed, total APCAs performed with relative frequency, total APUCAs performed with relative frequency, and odds ratio calculated all on an annual basis.
| Year | Total Appendectomies N (%) | AC 1 N (%) | Ac 2 N (%) | OR 3 |
|---|---|---|---|---|
| 2012 | 37,679 | 9791 (26%) | 27,888 (74.01%) | 0.12 |
| 2013 | 39,662 | 11,757 (29.6%) | 27,905 (70.4%) | 0.18 |
| 2014 | 37,450 | 11,717 (31.3%) | 25,733 (68.7%) | 0.2 |
| 2015 | 7896 | 3291 (41.6%) | 4605 (58.33%) | 0.52 |
| 2016 | 32,516 | 14,023 (43.12%) | 18,493 (56.9%) | 0.6 |
| 2017 | 29,354 | 13,209 (45%) | 16,145 (55%) | 0.67 |
| 2018 | 32,668 | 14,334 (43.8%) | 18,334 (56.2%) | 0.61 |
| 2019 | 27,365 | 9698 (35.4%) | 17,667 (64.6%) | 0.3 |
| 2020 | 25,175 | 10,270 (40.8%) | 14,905 (59.2%) | 0.48 |
| 2021 | 23,106 | 9013 (39%) | 14,093 (61%) | 0.41 |
1 AC: Appendectomies performed in patients with Complicated Appendectomies. 2 ac: Appendectomies performed in patients with Uncomplicated Appendectomies. 3 OR: Odds ratio comparing the odds of appendectomies in patients with Complicated Appendicitis to the odds of appendectomies in patients with Uncomplicated Appendicitis.
Table 3.
Numerical values for each of the six defined appendectomy subgroups (AMCC, ACC, AWC, amcc, acc, and awc), the total appendectomies performed in the ED, and the relative rate of each subgroup compared to the total number of appendectomies performed in the ED for each year from 2012 to 2021.
Table 3.
Numerical values for each of the six defined appendectomy subgroups (AMCC, ACC, AWC, amcc, acc, and awc), the total appendectomies performed in the ED, and the relative rate of each subgroup compared to the total number of appendectomies performed in the ED for each year from 2012 to 2021.
| Year | Total Appendectomies N (%) | AMCC 1 N (%) | ACC 2 N (%) | AWC 3 N (%) | amcc 4 N (%) | acc 5 N (%) | awc 6 N (%) |
|---|---|---|---|---|---|---|---|
| 2012 | 37,679 | 613 (1.6%) | 2802 (7.4%) | 6376 (17%) | 586 (1.56%) | 3162 (8.4%) | 24,140 (64.1%) |
| 2013 | 39,662 | 739 (1.8%) | 3330 (8.4%) | 7688 (19.3%) | 661 (1.66%) | 3559 (9%) | 23,685 (59.7%) |
| 2014 | 37,450 | 748 (2%) | 3440 (9.1%) | 7529 (20.1%) | 726 (1.94%) | 3505 (9.4%) | 21,502 (57.4%) |
| 2015 | 7896 | 214 (2.7%) | 913 (11.6%) | 2164 (27.4%) | 159 (2.02%) | 747 (9.5%) | 3699 (46.9%) |
| 2016 | 32,516 | 835 (2.6%) | 3981 (12.2%) | 9207 (28.3%) | 667 (2.06%) | 3027 (9.3%) | 14,799 (45.6%) |
| 2017 | 29,354 | 790 (2.7%) | 3837 (13.07%) | 8582 (29.2%) | 640 (2.1%) | 2704 (9.2%) | 12,801 (43.7%) |
| 2018 | 32,668 | 766 (2.3%) | 4288 (13.2%) | 9280 (28.4%) | 675 (2.06%) | 3163 (9.7%) | 14,496 (44.4%) |
| 2019 | 27,365 | 525 (1.92%) | 3326 (12.1%) | 5847 (21.4%) | 714 (2.6%) | 3440 (12.5%) | 13,513 (49.4%) |
| 2020 | 25,175 | 683 (2.8%) | 3543 (14.1%) | 6044 (24.01%) | 875 (3.4%) | 3133 (12.4%) | 10,897 (43.3%) |
| 2021 | 23,106 | 722 (3.1%) | 3150 (13.6%) | 5141 (22.2%) | 931 (4.03%) | 3191 (13.9%) | 9971 (43.15%) |
1 AMCC = Appendectomies performed in Complicated Appendicitis patients with Major Clinical Complication. 2 ACC = Appendectomies performed on patients with Complicated Appendicitis and Clinical Comorbidity. 3 AWC = Appendectomies in patients with Complicated Appendicitis but without Complications or Comorbidities. 4 amcc = Appendectomies performed in Uncomplicated Appendicitis patients with Major Clinical Complication. 5 acc = Appendectomies performed in Uncomplicated Appendicitis patients with Clinical Comorbidity. 6 awc = Appendectomies in patients with Uncomplicated Appendicitis without Comorbidities or Complications.
Table 4.
Table showcasing predicted numerical values for each of the six defined appendectomy subgroups (AMCC, ACC, AWC, amcc, acc, and awc), the total appendectomies performed in the ED, and the relative rate of each subgroup compared to the total number of appendectomies performed in the ED for each year from 2022 to 2032.
Table 4.
Table showcasing predicted numerical values for each of the six defined appendectomy subgroups (AMCC, ACC, AWC, amcc, acc, and awc), the total appendectomies performed in the ED, and the relative rate of each subgroup compared to the total number of appendectomies performed in the ED for each year from 2022 to 2032.
| Year | AMCC | ACC | AWC | amcc | acc | awc |
|---|---|---|---|---|---|---|
| 2022 | +700 | +3729 | +6442 | +866 | +3092 | +7397 |
| 2023 | +706 | +3814 | +6380 | +902 | +3116 | +6024 |
| 2024 | +713 | +3899 | +6317 | +939 | +3139 | +4651 |
| 2025 | +719 | +3984 | +6255 | +976 | +3163 | +3278 |
| 2026 | +726 | +4069 | +6192 | +1013 | +3186 | +1904 |
| 2027 | +733 | +4154 | +6130 | +1049 | +3210 | +531 |
| 2028 | +739 | +4239 | +6067 | +1086 | +3233 | −842 |
| 2029 | +746 | +4324 | +6005 | +1123 | +3257 | −2216 |
| 2030 | +752 | +4409 | +5942 | +1160 | +3280 | −3589 |
| 2031 | +759 | +4494 | +5880 | +1196 | +3304 | −4962 |
| 2032 | +765 | +4579 | +5817 | +1233 | +3327 | −6335 |
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Aalam, A.A.; Iftikhar, N.; Ain, H.u.; Batool, F.; Mulkerin, W.; Loftus, T.J.; Striley, C.W. Temporal Analysis of Nationwide Emergency Department Utilization and Appendectomy Trends. Emerg. Care Med. 2025, 2, 22. https://doi.org/10.3390/ecm2020022
AMA Style
Aalam AA, Iftikhar N, Ain Hu, Batool F, Mulkerin W, Loftus TJ, Striley CW. Temporal Analysis of Nationwide Emergency Department Utilization and Appendectomy Trends. Emergency Care and Medicine. 2025; 2(2):22. https://doi.org/10.3390/ecm2020022
Chicago/Turabian StyleAalam, Ali A., Nofel Iftikhar, Hoor ul Ain, Fahama Batool, William Mulkerin, Tyler J. Loftus, and Catherine W. Striley. 2025. "Temporal Analysis of Nationwide Emergency Department Utilization and Appendectomy Trends" Emergency Care and Medicine 2, no. 2: 22. https://doi.org/10.3390/ecm2020022
APA StyleAalam, A. A., Iftikhar, N., Ain, H. u., Batool, F., Mulkerin, W., Loftus, T. J., & Striley, C. W. (2025). Temporal Analysis of Nationwide Emergency Department Utilization and Appendectomy Trends. Emergency Care and Medicine, 2(2), 22. https://doi.org/10.3390/ecm2020022
