Changes in the management of acute appendicitis during the COVID-19 pandemic

Lock, Johan Friso; Wiegering, Armin

doi:10.1007/s00423-021-02099-8

Cited by 8 publications

(9 citation statements)

References 10 publications

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“…Failure to access life-saving treatments can increase the severity of the disease, causing complications and even death [ 6 ]. During the COVID-19 pandemic, changes in the diagnosis and treatment results for abdominal pain requiring surgery, such as acute appendicitis, and even changes in treatment trends, have been actively reported [ 7 , 8 , 9 , 10 , 11 , 12 ]. On the other hand, there have been few reports of intussusceptions in pediatric patients.…”

Section: Introductionmentioning

confidence: 99%

Impact of the COVID-19 Pandemic on Emergency Care Utilization and Outcomes in Pediatric Patients with Intussusception

Lee

Kwon

et al. 2022

Children

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Background: We determined whether a decrease in healthcare utilization patterns during the COVID-19 pandemic affected the treatment process of pediatric patients with intussusception. Methods: Patients with suspected intussusception who had ICD-10 code K561 as their discharge diagnosis from the national database were selected, and those who underwent either radiologic and/or surgical reduction were defined as true intussusception patients. We compared the time periods from patients visiting the ED to ultrasound, radiologic reduction and/or surgical reduction between the study group (first half of 2020, COVID-19 period) and the control groups (control group 1: first half of 2019, control group 2: second half of 2019). Results: The number of suspected intussusception patients in each group was 1223, 1576, and 624, and the incidence rates were 7.85, 11.30, and 4.19 per 100,000 person-half-years (control group 1, control group 2, study group, respectively, p < 0.05). No differences in terms of the time from the ED visit to ultrasound, radiological reduction and/or surgical reduction were noted between the study group and the control groups. Conclusions: In Korea, the COVID-19 pandemic did not significantly affect the ED treatment process or the results of patients with intussusception.

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Section: Introductionmentioning

confidence: 99%

Impact of the COVID-19 Pandemic on Emergency Care Utilization and Outcomes in Pediatric Patients with Intussusception

Lee

Kwon

et al. 2022

Children

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“…Moreover, the guidelines regarding the management of acute appendicitis were also modified towards conservative management to avoid long surgical lists. A number of recent studies across Europe, USA and India support the idea of conservative management of Appendicitis with oral or Intravenous antibiotics only with observation not only in adults but also in children 4,5,6 .…”

Section: Introductionmentioning

confidence: 99%

Influence of Covid -19 on the management of Appendicitis

Zahra¹,

Kashif²,

Ahmed³

et al. 2021

PJMHS

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Objective: Acute Appendicitis encounters as the frequent problem in surgical pediatric patients leading to Appendectomy, being one of the most common procedures performed in surgical Emergency. During COVID-19 pandemic, the trends in the management of acute appendicitis have changed. Conservative management of appendicitis with antibiotics is being proposed as an alternative to conventional appendectomy. So, this study is conducted to compare the presentation and outcome of Appendicitis managed during pre and post pandemic period in our settings. Methodology: After approval of Ethical Review Committee, a total of 267 patients of age 1-12 years were selected for the study. It was a retrospective Cohort Study. Patients were divided into group A (n=145) which was pre pandemic group. Data was collected retrospectively from charts regarding demographics, presentation, duration of stay operative findings and complications from May-Oct 2019 and Group B (n=122) during covid-19 was collected from the patients presented with appendicitis over a period of six months from May-Oct 2020 . Similar months of the year were selected to remove seasonal variation in the presentation of Appendicitis. All information was collected on a predesigned Performa. Data was compared and analyzed on SPSS 20. Results: Out of 267 patients, 151 (56.56%) were male. Group A patients presented during pre-pandemic period (n=145) were undergone appendectomy for appendicitis in 129 patients (88.96%) with 59 patients (40.68%) having acutely inflamed appendix and 70 patients (48.27%) had complicated appendicitis such as gangrenous, perforated with generalized peritonitis. In Group A only 16 patients (11.03%) were managed conservatively for appendicular mass. In contrast to group B (n=122) presented during pandemic, only 43 patients (35.24%) were operated with findings of acutely inflamed appendicitis while gangrenous/perforated appendicitis with pelvic abscess and/or generalized peritonitis was found in most of the patients with a number of 69 (56.55%), only 10 (8.19%) patient presented as Appendicular mass hence managed conservatively. Conclusion: Delay in presentation and early conservative management during pandemic crisis has resulted in an increase in the complications of Appendicitis. Early referral to specialized centers with vigilant selection for conservative treatment can save patients from developing complications. Keywords: Appendicitis, covid-19, Appendectomy, complications, Pandemic

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“…-In March 2020, 4.8% of patients with acute appendicitis had a concomitant COVID-19 infection. [42][43][44] These results show that a shift to medical treatment of appendicitis or change in surgical technique due to the pandemic did not lead to clear evidence emerging of an improvement in patient safety.…”

Section: Medical Instead Of Surgical Management During the Covid-19 Pandemic?mentioning

confidence: 88%

Patient, Surgeon, and Health Care Worker Safety during the COVID-19 Pandemic

Hölscher¹

2021

Annals of Surgery

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PATIENT SAFETYT he painting of Pablo Picasso from 1897 entitled ''Ciencia y Caridad'' describes 2 aspects of patient safety very well (Fig. 1). At the center of the tableau is a bedridden patient. The physician measures the pulse while looking gravely and concentratedly at his pocket watch. He represents in the interpretation of Picasso, whose uncle was a physician, the rational and scientific aspects of treatment. The nun looks toward the patient, serves fluid, and takes care of the patient's child. She stands in this painting from the century before last for the emotional and practical aspects of care. Both are important for the safety and wellbeing of our patients. The patient should feel secure and confident by virtue of receiving both empathic and scientifically grounded safe treatment under the maxim ''primum nihil nocere.'' ''Patient safety is a framework of organized activities that creates cultures, processes, procedures, behaviors, technologies, and environment in health care that consistently and sustainably lower risks, reduce the occurrence of avoidable harm, make error less likely, and reduce its impact when it does occur.'' 1 Undoubtedly securing patient safety now requires teamwork, but in the case of surgical treatment patient safety nevertheless remains a paramount issue for the surgeon, who will often have been chosen personally by the patient. 2 The surgeon assumes responsibility for his patient and accompanies him during the pre, intra-and postoperative periodslonger than all other contributing allied disciplines. This results in a special, close, and reciprocal relationship and the patient will ultimately see the surgeon as primarily responsible for the success or failure of the treatment as a whole. Burden of Impaired Patient Safety Before the COVID-19 PandemicMany medical centers, health care systems, national and international organizations have made great efforts to analyses the frequency of adverse medical events and to determine their origins to establish best procedures and guidelines for their prevention. [3][4][5][6][7][8] The central aims of these efforts were firstly to reduce the burden of morbidity and mortality borne by patients and their families and secondly to reduce both the enormous costs of subsequent treatment and litigation, and the wider economic consequences of disability and unemployment.On average 1 in every 10 patients experiences an adverse event while receiving hospital care in high-income countries. 1 The most frequently occurring adverse events are health careassociated infections, venous thromboembolism, adverse drug events, pressure injuries, diagnostic errors, and wrong site surgeries. 3 In high-income countries up to 15% of hospital expenditure is spent on preventable safety failures. 3 The WHO Regional Office for Europe reported in 2019 that >750,000 medical errors resulting in harm occur in Europe each year, including 260,000 incidents resulting in permanent disability and almost 100,000 incidents resulting in death; all of which leads to >3.2 million add...

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Changes in the management of acute appendicitis during the COVID-19 pandemic

Cited by 8 publications

References 10 publications

Impact of the COVID-19 Pandemic on Emergency Care Utilization and Outcomes in Pediatric Patients with Intussusception

Impact of the COVID-19 Pandemic on Emergency Care Utilization and Outcomes in Pediatric Patients with Intussusception

Influence of Covid -19 on the management of Appendicitis

Patient, Surgeon, and Health Care Worker Safety during the COVID-19 Pandemic

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