Higher Rates of Complicated Appendicitis During the COVID-19 Pandemic: A Year-to-Year Analysis

The COVID-19 pandemic impacted presentation, management strategies, and patient outcomes of numerous medical conditions. The aim of this study is to perform a year-to-year comparison of clinical outcomes of patients with acute appendicitis (AA) before and during the pandemic. Patients treated for AA...

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Bibliographic Details
Published in:The Journal of surgical research 2023-10, Vol.290, p.304-309
Main Authors: Kupietzky, Amram, Finkin, Miriam, Dover, Roi, Eliezer Lourie, Nachum Emil, Mordechai-heyn, Tzlil, Juster, Eyal Yonathan, Mazeh, Haggi, Mizrahi, Ido
Format: Article
Language:English
Subjects:
Abscess
Acute appendectomy
Acute appendicitis
Appendectomy - methods
Appendicitis - complications
Appendicitis - epidemiology
Appendicitis - surgery
Conservative treatment
Coronavirus SARS-CoV-2
COVID-19
COVID-19 - complications
COVID-19 - epidemiology
Female
Humans
Male
Nonoperative management
Pandemics
Retrospective Studies
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Summary:The COVID-19 pandemic impacted presentation, management strategies, and patient outcomes of numerous medical conditions. The aim of this study is to perform a year-to-year comparison of clinical outcomes of patients with acute appendicitis (AA) before and during the pandemic. Patients treated for AA during the initial 12-mo period of the pandemic at our institute were compared to those treated for AA during the 12-mo period before. Clinical and laboratory parameters, treatment strategies, intraoperative findings, pathology reports, and postoperative outcomes were compared. During the study period, 541 patients presented with AA. The median (interquartile range) age was 28 (21-40) y and 292 (54%) were males. 262 (48%) patients presented during the pre-COVID-19 period, while 279 patients (52%) presented during the COVID 19 pandemic. The groups were comparable for baseline clinical data and imaging results upon index admission. There was no significant difference in rate of nonoperative treatment between the Pre-COVID-19 and During-COVID-19 eras (51% versus 53%, P = 0.6) as well as the success rate of such treatment (95.4% versus 96.4%, P = 0.3). Significantly more patients presented with a periappendicular abscess during COVID-19 (4.6% versus 1.1%, P = 0.01) and median (interquartile range) operative time was significantly longer (78 (61-90) versus 32.5 (27-45) min, P 
ISSN:0022-4804
1095-8673
DOI:10.1016/j.jss.2023.05.007