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Managing appendicitis during the COVID-19 era: A single centre experience & implications for future practice.
Oreoluwa Bajomo1, Rumneek Hampal2, Paul Sykes3
1Royal Liverpool University Trust Hospital, Prescot Street, Liverpool, L7 8XP, UK.
Annals of Medicine and Surgery (2012)
|February 22, 2021
Summary
During the COVID-19 pandemic, appendicitis patients presented with more severe disease but received more efficient care. Laparoscopic surgery and quicker diagnostics were highlighted, despite increased surgical site infections.
Area of Science:
- General Surgery
- Infectious Disease Epidemiology
Background:
- The COVID-19 pandemic necessitated modifications to emergency surgical practices, impacting appendicitis management.
- Royal College guidance adapted surgical protocols to the evolving pandemic climate.
Purpose of the Study:
- To compare the presentation, investigation, surgical management, and outcomes of appendicitis before and during the COVID-19 pandemic.
- To assess changes in length of stay, readmissions, and postoperative wound infection rates.
Main Methods:
- A comparative study of appendicitis patients over two 8-week periods: pre-pandemic and during the COVID-19 pandemic.
- Data collected included disease severity, diagnostic methods (CT scans), surgical approach (laparoscopic vs. open), and patient outcomes.
Main Results:
- Patients during the pandemic showed higher inflammatory markers (CRP) and more severe appendicitis histologically.
- Laparoscopic appendicectomy rates decreased significantly (85% pre-pandemic vs. 50% during pandemic).
- Shorter hospital stays were observed during the pandemic, but with increased surgical site infections and reattendance rates.
Conclusions:
- The study underscores the efficiency of services and diagnostic methods during the COVID-19 era, despite increased disease severity.
- Laparoscopic surgery remains a beneficial approach for appendicitis management.
- Pandemic conditions led to changes in appendicitis treatment pathways and outcomes.
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