Variations in clinical course and surgical outcomes of acute appendicitis during COVID-19 Pandemic: a multicenter cohort study
Abstract Background COVID-19 pandemic has led to changes in the presentation and treatment of surgical pathologies. Therefore, we aim to describe the influence of the COVID-19 pandemic on the clinical presentation and management of acute appendicitis (AAp) and its surgical outcomes. Study design A m...
| Main Authors: | , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2023-03-01
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| Series: | BMC Surgery |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12893-023-01933-8 |
| _version_ | 1797865710021509120 |
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| author | Carlos Eduardo Rey Chaves Felipe Girón Ricardo E. Núñez-Rocha Elkin Benítez Saralia Ruiz Lina Rodríguez Daniela Ayala Carlos José Villamil Valentina Galvis Marco Vanegas Mónica Gómez Ricardo Nassar Juan David Hernández Danny Conde María Gómez Zuleta |
| author_facet | Carlos Eduardo Rey Chaves Felipe Girón Ricardo E. Núñez-Rocha Elkin Benítez Saralia Ruiz Lina Rodríguez Daniela Ayala Carlos José Villamil Valentina Galvis Marco Vanegas Mónica Gómez Ricardo Nassar Juan David Hernández Danny Conde María Gómez Zuleta |
| author_sort | Carlos Eduardo Rey Chaves |
| collection | DOAJ |
| description | Abstract Background COVID-19 pandemic has led to changes in the presentation and treatment of surgical pathologies. Therefore, we aim to describe the influence of the COVID-19 pandemic on the clinical presentation and management of acute appendicitis (AAp) and its surgical outcomes. Study design A multicenter cohort study with prospectively collected databases. Three high-volume centers were included and all patients over 18 years of age who underwent appendectomy for AAp were included. Multiple logistic regression and multinomial logistic regression were performed, and odds ratio, relative risk, and B-coefficient were reported when appropriate, statistical significance was reached with p-values < 0.05. Results 1.468 patients were included (709 in the pre-pandemic group and 759 in the COVID-19 group). Female patients constituted 51.84%. Mean age was 38.13 ± 16.96 years. Mean Alvarado’s score was 7.01 ± 1.59 points. Open surgical approach was preferred in 90.12%. Conversion rate of 1.29%. Mortality rate was 0.75%. There was an increase of perforated and localized peritonitis (p 0.01) in the COVID-19 group. Presence of any postoperative complication (p 0.00), requirement of right colectomy and ileostomy (p 0.00), and mortality (p 0.04) were higher in the COVID-19 group. Patients in the pre-pandemic group have a lesser risk of mortality (OR 0.14, p 0.02, 95% CI 0.02–0.81) and a lesser relative risk of having complicated appendicitis (RR 0.68, p 0.00, 95% CI 0.54–0.86). Conclusion Complicated appendicitis was an unexpected consequence of the COVID-19 pandemic, due to surgical consultation delay, increased rates of morbidity, associated procedures, and mortality, influencing the clinical course and surgical outcomes of patients with AAp. |
| first_indexed | 2024-04-09T23:13:38Z |
| format | Article |
| id | doaj.art-f41b8f01200b4ee6b0e91cbbac6fde95 |
| institution | Directory Open Access Journal |
| issn | 1471-2482 |
| language | English |
| last_indexed | 2024-04-09T23:13:38Z |
| publishDate | 2023-03-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Surgery |
| spelling | doaj.art-f41b8f01200b4ee6b0e91cbbac6fde952023-03-22T10:17:58ZengBMCBMC Surgery1471-24822023-03-0123111010.1186/s12893-023-01933-8Variations in clinical course and surgical outcomes of acute appendicitis during COVID-19 Pandemic: a multicenter cohort studyCarlos Eduardo Rey Chaves0Felipe Girón1Ricardo E. Núñez-Rocha2Elkin Benítez3Saralia Ruiz4Lina Rodríguez5Daniela Ayala6Carlos José Villamil7Valentina Galvis8Marco Vanegas9Mónica Gómez10Ricardo Nassar11Juan David Hernández12Danny Conde13María Gómez Zuleta14Department of Surgery and Specialties, Pontificia Universidad JaverianaDepartment of Surgery, Fundación Santa Fé de BogotáSchool of Medicine, Universidad de los AndesSchool of Medicine, Fundación Universitaria Juan N. CorpasSchool of Medicine, Universidad del RosarioSchool of Medicine, Universidad de los AndesSchool of Medicine, Universidad del RosarioSchool of Medicine, Universidad del RosarioSchool of Medicine, Universidad del RosarioSchool of Medicine, Universidad del RosarioSchool of Medicine, Universidad del RosarioDepartment of Surgery, Fundación Santa Fé de BogotáDepartment of Surgery, Fundación Santa Fé de BogotáSchool of Medicine, Universidad del RosarioDepartment of Surgery and Specialties, Pontificia Universidad JaverianaAbstract Background COVID-19 pandemic has led to changes in the presentation and treatment of surgical pathologies. Therefore, we aim to describe the influence of the COVID-19 pandemic on the clinical presentation and management of acute appendicitis (AAp) and its surgical outcomes. Study design A multicenter cohort study with prospectively collected databases. Three high-volume centers were included and all patients over 18 years of age who underwent appendectomy for AAp were included. Multiple logistic regression and multinomial logistic regression were performed, and odds ratio, relative risk, and B-coefficient were reported when appropriate, statistical significance was reached with p-values < 0.05. Results 1.468 patients were included (709 in the pre-pandemic group and 759 in the COVID-19 group). Female patients constituted 51.84%. Mean age was 38.13 ± 16.96 years. Mean Alvarado’s score was 7.01 ± 1.59 points. Open surgical approach was preferred in 90.12%. Conversion rate of 1.29%. Mortality rate was 0.75%. There was an increase of perforated and localized peritonitis (p 0.01) in the COVID-19 group. Presence of any postoperative complication (p 0.00), requirement of right colectomy and ileostomy (p 0.00), and mortality (p 0.04) were higher in the COVID-19 group. Patients in the pre-pandemic group have a lesser risk of mortality (OR 0.14, p 0.02, 95% CI 0.02–0.81) and a lesser relative risk of having complicated appendicitis (RR 0.68, p 0.00, 95% CI 0.54–0.86). Conclusion Complicated appendicitis was an unexpected consequence of the COVID-19 pandemic, due to surgical consultation delay, increased rates of morbidity, associated procedures, and mortality, influencing the clinical course and surgical outcomes of patients with AAp.https://doi.org/10.1186/s12893-023-01933-8AppendicitisCOVID 19Multicenter studyOutcomesSARS-CoV-2Surgery |
| spellingShingle | Carlos Eduardo Rey Chaves Felipe Girón Ricardo E. Núñez-Rocha Elkin Benítez Saralia Ruiz Lina Rodríguez Daniela Ayala Carlos José Villamil Valentina Galvis Marco Vanegas Mónica Gómez Ricardo Nassar Juan David Hernández Danny Conde María Gómez Zuleta Variations in clinical course and surgical outcomes of acute appendicitis during COVID-19 Pandemic: a multicenter cohort study BMC Surgery Appendicitis COVID 19 Multicenter study Outcomes SARS-CoV-2 Surgery |
| title | Variations in clinical course and surgical outcomes of acute appendicitis during COVID-19 Pandemic: a multicenter cohort study |
| title_full | Variations in clinical course and surgical outcomes of acute appendicitis during COVID-19 Pandemic: a multicenter cohort study |
| title_fullStr | Variations in clinical course and surgical outcomes of acute appendicitis during COVID-19 Pandemic: a multicenter cohort study |
| title_full_unstemmed | Variations in clinical course and surgical outcomes of acute appendicitis during COVID-19 Pandemic: a multicenter cohort study |
| title_short | Variations in clinical course and surgical outcomes of acute appendicitis during COVID-19 Pandemic: a multicenter cohort study |
| title_sort | variations in clinical course and surgical outcomes of acute appendicitis during covid 19 pandemic a multicenter cohort study |
| topic | Appendicitis COVID 19 Multicenter study Outcomes SARS-CoV-2 Surgery |
| url | https://doi.org/10.1186/s12893-023-01933-8 |
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