Acute appendicitis in elderly during Covid-19 pandemic

Area of Science:

• Geriatric Surgery
• Emergency Medicine
• Epidemiology

Background:

• Hospital access restrictions during the pandemic led to delayed treatment for non-traumatic abdominal emergencies.
• Evidence-based recommendations for managing acute appendicitis in elderly patients during the pandemic were lacking.

Purpose of the Study:

• To assess the impact of the pandemic on the management of acute appendicitis in patients over 68 years old.
• To compare surgical outcomes and complication rates before and during the pandemic.

Main Methods:

• Retrospective analysis of patients over 68 who underwent appendectomy between February 2020 and December 2020.
• Comparison with a similar cohort from the pre-pandemic period.
• Data included surgical approach, hospital stay, and post-operative complications.

Main Results:

• During the pandemic, 59.3% of cases had complicated appendicitis, compared to 26.5% pre-pandemic.
• Laparoscopic appendectomy rates decreased, with increased conversions to laparotomy (22.3% vs 14.7%).
• Mean hospital stay increased to 5.64 days during the pandemic from 4.21 days prior.

Conclusions:

• Pandemic conditions contributed to delayed diagnosis in elderly patients with acute appendicitis.
• An increase in complicated appendicitis was observed, evidenced by higher rates of conversion to laparotomy.