Global trends and inequalities in appendicitis burden among youth: Analysis of GBD 1990 to 2021.

Appendicitis is a common digestive system disorder worldwide. This study aims to assess the global pattern and trends of appendicitis burden in adolescents and young adults as well as its health inequalities from 1990 to 2021. In this descriptive cross-sectional ecological study, we downloaded data on the incidence, death, and disability-adjusted life years (DALYs) due to appendicitis among people aged 10 to 24 years from the Global Burden of Disease 2021. We evaluated the age-standardized incidence rate (ASIR), average annual percentage change (AAPC), and sociodemographic index (SDI). The slope index and the concentration index were calculated to assess cross-national health inequalities. From 1990 to 2021, the global age-standardized incidence and DALY rates of appendicitis in adolescents and young adults showed downward trends, with an AAPC of -0.18 (-0.2 to -0.17) and -2.4 (-2.47 to -2.32), respectively. An increasing trend in incidence was observed in the 10 to 14 age group (AAPC = 0.06). At the regional level, the highest ASIR was observed in High-income Asia Pacific (741.8) in 2021, and the highest age-standardized DALY rate was observed in Andean Latin America (32.5). There was a trend at the national level of increasing ASIR along with increases in SDI, and the relationship between DALY and SDI followed an inverse U-shaped pattern. The slope index decreased from -19.98 (95% confidence interval [CI] = -23.79 to -16.17) in 1992 to -12.13 (95% CI = -14.35 to -9.91) in 2021. The concentration index also decreased from -0.33 (95% CI = -0.39 to -0.26) in 1992 to -0.19 (95% CI = -0.23 to -0.14) in 2021. While the global age-standardized incidence and DALY rates of appendicitis in adolescents and young adults declined from 1990 to 2021, an increasing trend of ASIR was observed in the 10 to 14 age group. Although the cross-national inequalities have diminished over time, they remain a public health concern.