Towards ambulatorization of appendectomy: Lessons learned during the pandemic

Area of Science:

• Surgery
• Public Health
• Epidemiology

Background:

• Acute appendicitis is a common surgical emergency globally.
• The COVID-19 pandemic prompted investigations into its impact on appendicitis diagnosis, treatment, and management, including outpatient care.
• This study examines appendicitis cases during the COVID-19 State of Emergency (SOE).

Purpose of the Study:

• To characterize acute appendicitis cases treated during the COVID-19 SOE.
• To evaluate the feasibility of incorporating appendicitis treatment into ambulatory surgery programs.
• To assess the influence of the COVID-19 lockdown on appendicitis management and outcomes.

Main Methods:

• Retrospective observational study of patients with appendix diseases (K35-K38) at public hospitals.
• Collection and analysis of sociodemographic and clinical data.
• Multivariate analysis to determine the influence of the lockdown on key variables.

Main Results:

• 201 patients were analyzed; 78 during SOE and 123 pre-SOE.
• Increased risk of complicated appendicitis with age (OR 1.015, p=0.000).
• Longer surgery time significantly increased postsurgical complication risk (OR 7.265, p=0.000).
• Hospital stay length significantly decreased during lockdown (p=0.017).

Conclusions:

• The COVID-19 lockdown did not adversely affect morbidity or mortality for complicated acute appendicitis.
• Reduced hospital stays during lockdown support the potential for outpatient appendicitis treatment.
• Findings suggest that appendicitis management can be adapted for ambulatory surgery settings.