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10.1308/rcsann.2021.0089

http://scihub22266oqcxt.onion/10.1308/rcsann.2021.0089
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34192486!10334878!34192486
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suck abstract from ncbi


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pmid34192486      Ann+R+Coll+Surg+Engl 2021 ; 103 (7): 481-486
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  • Appendicitis in the COVID-19 era: a modern challenge for experienced hands #MMPMID34192486
  • Brown C; Waterman J; El Hitti E; Luton O; Joseph A; Pollitt MJ; Thippeswamy K; Robinson D
  • Ann R Coll Surg Engl 2021[Jul]; 103 (7): 481-486 PMID34192486show ga
  • INTRODUCTION: The first wave of COVID-19 was accompanied by global uncertainty. Delayed presentation of patients to hospitals ensued, with surgical pathologies no exception. This study aimed to assess whether delayed presentations resulted in more complex appendicectomies during the first wave of COVID-19. METHODS: Operation notes for all presentations of appendicitis (n=216) within a single health board (three hospitals) during two three-month periods (control period (pre-COVID) vs COVID pandemic) were analysed, and the severity of appendicitis was recorded as per the American Association for the Surgery of Trauma (AAST) grading system. RESULTS: Presentations of appendicitis were delayed during the COVID period with a median duration of symptoms prior to hospital attendance of two days versus one day (p=0.003) with individuals presenting with higher median white cell count than during the control period (14.9 vs 13.3, p=0.031). Use of preoperative CT scanning (OR 3.013, 95% CI 1.694-5.358, p<0.001) increased significantly. More complex appendicectomies (AAST grade >1) were performed (OR 2.102, 95% CI 1.155-3.826, p=0.015) with a greater consultant presence during operations (OR 4.740, 95% CI 2.523-8.903, p<0.001). Despite the greater AAST scores recorded during the COVID period, no increase in postoperative complications was observed (OR 1.145, 95% CI 0.404-3.244, p=0.798). CONCLUSIONS: Delayed presentations during the COVID-19 pandemic were associated with more complex cases of appendicitis. Important lessons can be learnt from the changes in practice employed as a result of this global pandemic.
  • |*Severity of Illness Index[MESH]
  • |Adolescent[MESH]
  • |Adult[MESH]
  • |Appendectomy/adverse effects/*methods/statistics & numerical data/trends[MESH]
  • |Appendicitis/blood/*diagnosis/surgery[MESH]
  • |Appendix/diagnostic imaging[MESH]
  • |COVID-19 Testing/statistics & numerical data[MESH]
  • |COVID-19/*epidemiology/prevention & control/transmission[MESH]
  • |Humans[MESH]
  • |Infection Control/standards[MESH]
  • |Length of Stay/statistics & numerical data[MESH]
  • |Lymphocyte Count[MESH]
  • |Male[MESH]
  • |Middle Aged[MESH]
  • |Pandemics/prevention & control[MESH]
  • |Postoperative Complications/epidemiology/etiology[MESH]
  • |Retrospective Studies[MESH]
  • |SARS-CoV-2/isolation & purification[MESH]
  • |Time-to-Treatment/*statistics & numerical data/trends[MESH]
  • |Tomography, X-Ray Computed/statistics & numerical data/trends[MESH]


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