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Acute appendicitis in elderly during Covid-19 pandemic

PURPOSE: During the past months, the Italian Government has reduced the restrictions and access to hospitals. Since then, up to 40% of non-traumatic abdominal emergencies have had unusual delayed treatment. Given the rapidly evolving situation and the absence of evidence to support recommendations d...

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Autores principales: Lisi, G., Campanelli, M., Mastrangeli, M. R., Grande, S., Viarengo, M. A., Garbarino, G. M., Vanni, G., Grande, M.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Berlin Heidelberg 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8159028/
https://www.ncbi.nlm.nih.gov/pubmed/34046696
http://dx.doi.org/10.1007/s00384-021-03959-x
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author Lisi, G.
Campanelli, M.
Mastrangeli, M. R.
Grande, S.
Viarengo, M. A.
Garbarino, G. M.
Vanni, G.
Grande, M.
author_facet Lisi, G.
Campanelli, M.
Mastrangeli, M. R.
Grande, S.
Viarengo, M. A.
Garbarino, G. M.
Vanni, G.
Grande, M.
author_sort Lisi, G.
collection PubMed
description PURPOSE: During the past months, the Italian Government has reduced the restrictions and access to hospitals. Since then, up to 40% of non-traumatic abdominal emergencies have had unusual delayed treatment. Given the rapidly evolving situation and the absence of evidence to support recommendations during the pandemic, it is useful to assess how the current situation is influencing the management of elderly with acute appendicitis. METHODS: Between February 2020 and December 2020, all patients older than 68 years old undergone appendectomy were included. Surgical approach, hospital stay, post-operative complications, radiology reports, and histologic examination were included in the retrospective analysis and compared with a same sample of the same period before the pandemic. RESULTS: Twenty-seven patients underwent appendectomy for acute appendicitis during the pandemic and 34 patients in the pre-outbreak period. Laparoscopic approach was completed in 51.8% of the cases, while conversion to laparotomy in 22.3% of patients and open procedure in the 25.9%, before the pandemic 73.6%, 14.7%, and 11.7%, respectively. During the pandemic, complicated appendicitis occurred in 59.3% of the cases (26.5% before the outbreak). One patient was treated for a pelvic abscess, while no minor complications were detected. No mortality rate was reported, with a mean hospital stay of 5.64 days during the outbreak and 4.21 days before the pandemic. CONCLUSION: Our data highlighted a partial delay in diagnosis in the elderly group, and an increase in complicated appendicitis also demonstrated by the need for conversion to laparotomy.
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spelling pubmed-81590282021-05-28 Acute appendicitis in elderly during Covid-19 pandemic Lisi, G. Campanelli, M. Mastrangeli, M. R. Grande, S. Viarengo, M. A. Garbarino, G. M. Vanni, G. Grande, M. Int J Colorectal Dis Short Communication PURPOSE: During the past months, the Italian Government has reduced the restrictions and access to hospitals. Since then, up to 40% of non-traumatic abdominal emergencies have had unusual delayed treatment. Given the rapidly evolving situation and the absence of evidence to support recommendations during the pandemic, it is useful to assess how the current situation is influencing the management of elderly with acute appendicitis. METHODS: Between February 2020 and December 2020, all patients older than 68 years old undergone appendectomy were included. Surgical approach, hospital stay, post-operative complications, radiology reports, and histologic examination were included in the retrospective analysis and compared with a same sample of the same period before the pandemic. RESULTS: Twenty-seven patients underwent appendectomy for acute appendicitis during the pandemic and 34 patients in the pre-outbreak period. Laparoscopic approach was completed in 51.8% of the cases, while conversion to laparotomy in 22.3% of patients and open procedure in the 25.9%, before the pandemic 73.6%, 14.7%, and 11.7%, respectively. During the pandemic, complicated appendicitis occurred in 59.3% of the cases (26.5% before the outbreak). One patient was treated for a pelvic abscess, while no minor complications were detected. No mortality rate was reported, with a mean hospital stay of 5.64 days during the outbreak and 4.21 days before the pandemic. CONCLUSION: Our data highlighted a partial delay in diagnosis in the elderly group, and an increase in complicated appendicitis also demonstrated by the need for conversion to laparotomy. Springer Berlin Heidelberg 2021-05-27 2021 /pmc/articles/PMC8159028/ /pubmed/34046696 http://dx.doi.org/10.1007/s00384-021-03959-x Text en © The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature 2021 This article is made available via the PMC Open Access Subset for unrestricted research re-use and secondary analysis in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the World Health Organization (WHO) declaration of COVID-19 as a global pandemic.
spellingShingle Short Communication
Lisi, G.
Campanelli, M.
Mastrangeli, M. R.
Grande, S.
Viarengo, M. A.
Garbarino, G. M.
Vanni, G.
Grande, M.
Acute appendicitis in elderly during Covid-19 pandemic
title Acute appendicitis in elderly during Covid-19 pandemic
title_full Acute appendicitis in elderly during Covid-19 pandemic
title_fullStr Acute appendicitis in elderly during Covid-19 pandemic
title_full_unstemmed Acute appendicitis in elderly during Covid-19 pandemic
title_short Acute appendicitis in elderly during Covid-19 pandemic
title_sort acute appendicitis in elderly during covid-19 pandemic
topic Short Communication
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8159028/
https://www.ncbi.nlm.nih.gov/pubmed/34046696
http://dx.doi.org/10.1007/s00384-021-03959-x
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