The Waterbury Democrat., 1935-09-18
APPENDICITIS KILLS RECORD NUMBER
Mortality in U. s. and Can- ada Greater Than That
 of Europe
fspecial to The Democrat)

Nav York. N. Y.-The puzzling fact that mortality from appendl- citis is greater in the United States and Canada than in Europeon coun- tries is brought to light by an anal yais of the death rates on this dis ease made by the statistical bureau of the Mtropolitan Life Insurance eompany, For the past few years tha death rate has averaged around IA to 15 per 100000 in the two American cities, whereas in Eu- rope it ranged from in Spain to 1a fin Switzerland. Furthermore. reIatiyelysuorekd die from 4appendt- eitis today in America than quar- ter of a cntury ago, despite wider knowledge of tn epatholofy or the disease, improved operative tech- naaue and added hospital facilities.
 The highest death rates from appendicitis, more than 20 per 100000 of population, are found in the states of Montana, Idaho, wyoming, Nevada, Utah and Colo rado. The Metropolitan statisti- clans point out that the chief ex- planation for these high rates lies in the factt hat nearly all of these states are sparsely inhabited and that population centers containing hospitals are few and far between. They add the comment:
 obviously, in these states per- sons stricken with appendicitis must lose much time at the critical moment before they can obtain proper hospital treatment.
 "It is . fact, fully established by all qualified investigators of the subject, that the chances of fatal outcome in this disease increase rapidly with the time elapsed be- tween onset and hospitalization. In other words, the patients chance of recovery depends almost entire- ly upon the speed with which he comes to operation. In these states, therefore, 1t is probable that the physical condition of patients ar- irving for operation is far lessj fa- vorable to recovery than is that of the average patient in other states where distances are no sogreat."
 The insurance company's statis- ticians note that in Canada also. tho highest appendicitis death rates are to be found in those prov 4nces where similar conditions pre- vail--where population is sparse and hospitals are often hard to Yeach. This is true in Alberta, where the highest appendicitis death rate in the dominion, 19 per 100, 900. ig reported.
 On the other hand, the relative ly night appendicitis death rates in Illinois, Michigan, Indiana and New York are accounted for by the fact that these states have ex- cept1onally fine hospital facilities, which attract many patients from nearby states. A certain percentage of these patients die and thus tend to swell the mortality rates for the states with more ample hospital accommodation.
 "It can readily be seen, then, why appendicitis death rates in America exceed those of European countries" the statisticians point out. "In Europe distances beSseen population centers are compara- lively small; hospitalization. conse- quently can be obtained more speedily. thereby greatly improving the patients chance of recovery. On the other hand, in large areas of America operation facilities are available, if at all, only after con- siderable difficulty and even hard ship on the part of the afflicted person."
 The statisticians draw the con- clusion that no great reduction of appendicitis mortality can be ef- fected in certain areas of the United States until either hospital or transportation facilities are greatly improved.