Multicenter cohort study on the presentation and treatment of acute appendicitis during the COVID-19 pandemic

Demi Huijgen, Elisabeth M.L. de Wijkerslooth, Josephine C. Janssen, Frédérique H. Beverdam, Evert Jan G. Boerma, Jan Willem T. Dekker, Sophia Kitonga, Charles C. van Rossem, Wilhelmina H. Schreurs, Boudewijn R. Toorenvliet, Maarten Vermaas, Bas P.L. Wijnhoven, Anne Loes van den Boom*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

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Abstract

Purpose: Current studies have demonstrated conflicting results regarding surgical care for acute appendicitis during the COVID-19 pandemic. This study aimed to assess trends in diagnosis as well as treatment of acute appendicitis in the Netherlands during the first and second COVID-19 infection wave. Methods: All consecutive patients that had an appendectomy for acute appendicitis in nine hospitals from January 2019 to December 2020 were included. The primary outcome was the number of appendectomies for acute appendicitis. Secondary outcomes included time between onset of symptoms and hospital admission, proportion of complex appendicitis, postoperative length of stay and postoperative infectious complications. Outcomes were compared between the pre-COVID group and COVID group. Results: A total of 4401 patients were included. The mean weekly rate of appendectomies during the COVID period was 44.0, compared to 40.9 in the pre-COVID period. The proportion of patients with complex appendicitis and mean postoperative length of stay in days were similar in the pre-COVID and COVID group (respectively 35.5% vs 36.8%, p = 0.36 and 2.0 ± 2.2 vs 2.0 ± 2.6, p = 0.93). There were no differences in postoperative infectious complications. A computed tomography scan was used more frequently as a diagnostic tool after the onset of COVID-19 compared to pre-COVID (13.8% vs 9.8%, p < 0.001, respectively). Conclusion: No differences were observed in number of appendectomies, proportion of complex appendicitis, postoperative length of stay or postoperative infectious complications before and during the COVID-19 pandemic. A CT scan was used more frequently during the COVID-19 pandemic.

Original languageEnglish
Pages (from-to)1087-1095
Number of pages9
JournalInternational Journal of Colorectal Disease
Volume37
Issue number5
DOIs
Publication statusPublished - May 2022

Bibliographical note

Funding Information:
E.M.L. de Wijkerslooth and A.L. van den Boom were supported by a grant from ZonMw (The Netherlands Organization for Health Research and Development; project no. 848015008). ZonMw had no role in the design or conduct of this study.

Publisher Copyright:
© 2022, The Author(s).

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