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2021 ; 56
(5
): 900-904
Nephropedia Template TP
gab.com Text
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English Wikipedia
Limiting hospital resources for acute appendicitis in children: Lessons learned
from the U S epicenter of the COVID-19 pandemic
#MMPMID32620267
Kvasnovsky CL
; Shi Y
; Rich BS
; Glick RD
; Soffer SZ
; Lipskar AM
; Dolgin S
; Bagrodia N
; Hong A
; Prince JM
; James DE
; Sathya C
J Pediatr Surg
2021[May]; 56
(5
): 900-904
PMID32620267
show ga
INTRODUCTION: The COVID-19 pandemic resulted in the suspension of nonemergent
surgeries throughout New York. Our tertiary care children's hospital pivoted
towards a brief trial of intravenous (IV) antibiotic therapy in all patients in
order to limit operating room (OR) utilization and avoid prolonged hospital
stays. We describe our pandemic-based strategy for non-operative management (NOM)
of appendicitis but with a limited duration of IV antibiotics. METHODS: We
performed a retrospective study of children treated for acute appendicitis at our
center from 3/31/2020 to 5/3/2020 during the peak of the New York pandemic. We
compared appendicitis volume to similar months in prior years. We evaluated
failure of NOM, length of stay, and compared characteristics of children we
successfully treated with our expanded NOM protocol to previously published
inclusion criteria for NOM. RESULTS: 45.5% of children (25/55) with acute
appendicitis underwent NOM. Of the 30 who underwent surgery, 13 had complicated
appendicitis while 17 had simple appendicitis. Three patients were
COVID-positive, although none had respiratory symptoms. The majority of patients
presenting with acute appendicitis (78.2%) did not meet previously published
criteria for NOM. CONCLUSIONS: We treated a similar volume of children with acute
appendicitis during the pandemic compared to prior years. We applied
non-operative management to nearly half our patients, even as we expanded
inclusion criteria for NOM to reduce OR utilization, but limited the duration of
the antibiotic trial to avoid prolonged hospital stays. TYPE OF STUDY:
Retrospective study. LEVEL OF EVIDENCE: IV.