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January 1950

ACUTE APPENDICITIS: Evaluation of Factors Contributing to the Decrease in Mortality in a Municipal Hospital Over A Twenty Year Period

Author Affiliations

From the Fourth Surgical Division, Bellevue Hospital.

Arch Surg. 1950;60(1):31-41. doi:10.1001/archsurg.1950.01250010047003

THE PRESENT decade has witnessed a spectacular drop in the mortality rate of acute appendicitis. This is nationwide and is reflected in the reports of small institutions1 as well as those of large centers. There were 14,113 fatalities due to appendicitis in the United States in 1939, while in 1946 there were only 5,285.2 Commenting on this progress, the Metropolitan Life Insurance Company3 stated: "There is good reason to believe that within the next few years appendicitis will be reduced to a very minor cause of death in our country, and that medical science and public health administration will close another important chapter in their history." That many factors are responsible for this improvement is illustrated by the divergence of surgical opinion on the role each has played. These tend to fall into four general headings: first, public health education with its resulting earlier seeking of treatment