S348 Global Trends in Appendicitis Burden in the United States (1990-2021): Insights From the GBD 2021 on Mortality, DALYs, and Incidence

Introduction: Appendicitis continues to be a major cause of surgical emergencies worldwide. Understanding long-term epidemiologic trends in disease burden is essential to guide clinical and public health strategies. Our aim to evaluate age-standardized trends in appendicitis-related mortality, disability-adjusted life years (DALYs), and incidence in the United States from 1990 to 2021, stratified by sex. Methods: Data were obtained from the Global Burden of Disease (GBD) 2021 dataset. We analyzed age-standardized rates per 100,000 for deaths, DALYs, and incidence across males, females, and both sexes combined. Estimates were reported with 95% uncertainty intervals (UIs). Trends were visualized over time using descriptive statistics and line plots. Results: Between 1990 and 2021 the age-standardized death rate decreased from 0.21 (95% UI: 0.20–0.22) to 0.14 (0.13–0.15) per 100,000. Males consistently had higher death rates than females. Among males, DALYs declined from 9.3 (8.8–9.9) to 6.8 (6.3–7.4); among females, from 6.5 (6.0–7.0) to 5.1 (4.6–5.7). Incidence rates also fell in males from 263 (255–270) to 246 (238–254), and in females from 244 (235–252) to 233 (225–240) per 100,000. All trends demonstrated steady improvement, with a persistent male predominance across all measures. Conclusion: Over 3 decades, the burden of appendicitis in the U.S. has significantly decreased in terms of incidence, DALYs, and mortality. These findings likely reflect improved diagnostics, early intervention, and surgical care. However, sex disparities persist, warranting further research into biological and healthcare access-related factors.