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Appendectomy and risk of Parkinson’s disease: A meta-analysis using real-world evidence

S. Hussain, A. Najmi (New Delhi, India)

Meeting: 2019 International Congress

Abstract Number: 2034

Keywords: Alpha-synuclein, Parkinsonism

Session Information

Date: Wednesday, September 25, 2019

Session Title: Surgical Therapy

Session Time: 1:15pm-2:45pm

Location: Les Muses Terrace, Level 3

Objective: This meta-analysis is aimed to explore the association between appendectomy and Parkinson’s disease (PD) risk.

Background: Parkinson’s disease is recently recognized as a systematic disease with prominent effects on the gut. Studies proposed movement of alpha-synuclein from the gut to the brain in PD and appendix has rich content of alpha-synuclein. Epidemiological studies found significant association between appendectomy and PD risk, while there are studies which found no association. So, this meta-analysis is aimed to understand the association between appendectomy and PD risk.

Method: PubMed, Embase and Cochrane database were searched for the published studies assessing the association between appendectomy and PD risk. Articles were searched through detailed search string consists of keywords related to appendectomy and PD till February 2019. Studies quality was assessed using the Newcastle-Ottawa scale. The primary outcome was to quantify the pooled PD risk in patients underwent surgery (appendectomy). Pooled risk based on sex, follow-up time and others were considered under secondary outcomes. Heterogeniety was assessed using Cochrane chi-square test and I2 test. Review Manager (RevMan v 5.3) was used for the statistical analysis.

Results: This meta-analysis was based on five articles comprised of 11,18,832 patients of whom 2,25,165 patients underwent surgery (appendectomy). All the included studies were of high quality. A detailed study design characteristics are presented in Table 1. A significant association was found between appendectomy and PD risk with a pooled relative risk (RR) of 1.10 (95% CI: 1.03 – 1.17), p = 0.006 (Fig.1). PD Risk was even higher in female patients who underwent appendectomy [RR 1.12 (95% CI: 1.00 – 1.25), p =0.04]. Appendectomy was not found to be associated with increased PD risk after 15 years of surgery (p = 0.58).

Conclusion: Appendectomy was found to be significantly associated with the small increase in PD risk. However, to confirm or counter the findings well-designed randomized controlled trials are warranted.

Table1

Fig.2

To cite this abstract in AMA style:

S. Hussain, A. Najmi. Appendectomy and risk of Parkinson’s disease: A meta-analysis using real-world evidence [abstract]. Mov Disord. 2019; 34 (suppl 2). https://www.mdsabstracts.org/abstract/appendectomy-and-risk-of-parkinsons-disease-a-meta-analysis-using-real-world-evidence/. Accessed June 14, 2025.
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