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Operative Management of Acute Appendicitis Was Safe During the COVID-19 Pandemic Shutdown

INTRODUCTION: In the spring of 2020, New York City was one of the first epicenters of the COVID outbreak. In this study, we evaluate the incidence and treatment of appendicitis in two New York City community hospitals during the COVID pandemic. METHODS: This retrospective study focused on the incide...

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Autores principales: Cheng, Olivia, Hu, James Y., Hong, Julie, Sarad, Nakia, Zenilman, Michael E., Chen, Chun-Cheng, Fahoum, Bashar, Lee, Roseanna S.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier Inc. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9892322/
https://www.ncbi.nlm.nih.gov/pubmed/36924622
http://dx.doi.org/10.1016/j.jss.2023.01.004
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author Cheng, Olivia
Hu, James Y.
Hong, Julie
Sarad, Nakia
Zenilman, Michael E.
Chen, Chun-Cheng
Fahoum, Bashar
Lee, Roseanna S.
author_facet Cheng, Olivia
Hu, James Y.
Hong, Julie
Sarad, Nakia
Zenilman, Michael E.
Chen, Chun-Cheng
Fahoum, Bashar
Lee, Roseanna S.
author_sort Cheng, Olivia
collection PubMed
description INTRODUCTION: In the spring of 2020, New York City was one of the first epicenters of the COVID outbreak. In this study, we evaluate the incidence and treatment of appendicitis in two New York City community hospitals during the COVID pandemic. METHODS: This retrospective study focused on the incidence and outcome of acute appendicitis in the adult population (>18 y old) during peak-COVID periods (March 16, 2020,-June 15, 2020) compared to pre-COVID and post-COVID periods. We compared the number of patients who underwent operative versus nonoperative management, patient demographics, length of stay (LOS), complications, and readmission rates within these time periods. Data are presented as mean ± standard deviation (analysis of variance). RESULTS: From January 1, 2020 to December 31, 2020, 393 patients presented with acute appendicitis and 321 (81.7%) were treated operatively, compared to 441 total and 366 treated operatively (83%) in 2019 (P = 0.88). During the COVID outbreak, fewer patients presented with appendicitis (mean 6.9 ± 1 pre-COVID case/week, 4.4 ± 2.4 peak-COVID cases/week and 7.6 ± 0.65 post-COVID cases/week, P = 0.018) with no significant difference in the pre-COVID and post-COVID period. There was no difference in LOS between the pre-, peak-, and post-COVID periods with a median of 1 for all the three, (interquartile range (IQR): 0.8-2, 0.6-2, 0.6-2, respectively, P = 0.43). Additionally, there was no difference in 30-day readmission rates (4.2%, 0%, 3.9%, P = 0.99) and postoperative complications (4.2%, 0%, 2.9%, P = 0.98). CONCLUSIONS: During peak-COVID, there was a significant reduction in the number of patients who presented with acute appendicitis without a post rebound increase in presentation. Those who presented during peak-COVID were able to undergo operative management safely, without affecting LOS or postoperative complications.
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spelling pubmed-98923222023-02-02 Operative Management of Acute Appendicitis Was Safe During the COVID-19 Pandemic Shutdown Cheng, Olivia Hu, James Y. Hong, Julie Sarad, Nakia Zenilman, Michael E. Chen, Chun-Cheng Fahoum, Bashar Lee, Roseanna S. J Surg Res Acute Care Surgery INTRODUCTION: In the spring of 2020, New York City was one of the first epicenters of the COVID outbreak. In this study, we evaluate the incidence and treatment of appendicitis in two New York City community hospitals during the COVID pandemic. METHODS: This retrospective study focused on the incidence and outcome of acute appendicitis in the adult population (>18 y old) during peak-COVID periods (March 16, 2020,-June 15, 2020) compared to pre-COVID and post-COVID periods. We compared the number of patients who underwent operative versus nonoperative management, patient demographics, length of stay (LOS), complications, and readmission rates within these time periods. Data are presented as mean ± standard deviation (analysis of variance). RESULTS: From January 1, 2020 to December 31, 2020, 393 patients presented with acute appendicitis and 321 (81.7%) were treated operatively, compared to 441 total and 366 treated operatively (83%) in 2019 (P = 0.88). During the COVID outbreak, fewer patients presented with appendicitis (mean 6.9 ± 1 pre-COVID case/week, 4.4 ± 2.4 peak-COVID cases/week and 7.6 ± 0.65 post-COVID cases/week, P = 0.018) with no significant difference in the pre-COVID and post-COVID period. There was no difference in LOS between the pre-, peak-, and post-COVID periods with a median of 1 for all the three, (interquartile range (IQR): 0.8-2, 0.6-2, 0.6-2, respectively, P = 0.43). Additionally, there was no difference in 30-day readmission rates (4.2%, 0%, 3.9%, P = 0.99) and postoperative complications (4.2%, 0%, 2.9%, P = 0.98). CONCLUSIONS: During peak-COVID, there was a significant reduction in the number of patients who presented with acute appendicitis without a post rebound increase in presentation. Those who presented during peak-COVID were able to undergo operative management safely, without affecting LOS or postoperative complications. Elsevier Inc. 2023-07 2023-02-02 /pmc/articles/PMC9892322/ /pubmed/36924622 http://dx.doi.org/10.1016/j.jss.2023.01.004 Text en © 2023 Elsevier Inc. All rights reserved. Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.
spellingShingle Acute Care Surgery
Cheng, Olivia
Hu, James Y.
Hong, Julie
Sarad, Nakia
Zenilman, Michael E.
Chen, Chun-Cheng
Fahoum, Bashar
Lee, Roseanna S.
Operative Management of Acute Appendicitis Was Safe During the COVID-19 Pandemic Shutdown
title Operative Management of Acute Appendicitis Was Safe During the COVID-19 Pandemic Shutdown
title_full Operative Management of Acute Appendicitis Was Safe During the COVID-19 Pandemic Shutdown
title_fullStr Operative Management of Acute Appendicitis Was Safe During the COVID-19 Pandemic Shutdown
title_full_unstemmed Operative Management of Acute Appendicitis Was Safe During the COVID-19 Pandemic Shutdown
title_short Operative Management of Acute Appendicitis Was Safe During the COVID-19 Pandemic Shutdown
title_sort operative management of acute appendicitis was safe during the covid-19 pandemic shutdown
topic Acute Care Surgery
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9892322/
https://www.ncbi.nlm.nih.gov/pubmed/36924622
http://dx.doi.org/10.1016/j.jss.2023.01.004
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