Where have all the appendicectomies gone?
| Autor: | Nicola Reeves, Anna Powell-Chandler, N G Mowbray, E Walters, L Hurt, J. Cornish, S Chandler |
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| Rok vydání: | 2021 |
| Předmět: |
Adult
Male medicine.medical_specialty 2019-20 coronavirus outbreak Delayed Diagnosis Coronavirus disease 2019 (COVID-19) Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) 030230 surgery Conservative Treatment Severity of Illness Index Health Services Accessibility 03 medical and health sciences 0302 clinical medicine Pandemic Severity of illness medicine Appendectomy Humans Prospective Studies Practice Patterns Physicians' Pandemics Aged Aged 80 and over Health professionals business.industry Incidence Incidence (epidemiology) COVID-19 General Medicine Middle Aged Patient Acceptance of Health Care Appendicitis medicine.disease United Kingdom Anti-Bacterial Agents Acute Disease Emergency medicine Female Surgery business |
| Zdroj: | The Annals of The Royal College of Surgeons of England. 103:250-254 |
| ISSN: | 1478-7083 0035-8843 |
| DOI: | 10.1308/rcsann.2020.7128 |
| Popis: | Introduction The COVID-19 pandemic stimulated a national lockdown in the UK. The public were advised to avoid unnecessary hospital attendances and health professionals were advised to avoid aerosol-generating procedures wherever possible. The authors hypothesised that these measures would result in a reduction in the number of patients presenting to hospital with acute appendicitis and alter treatment choices. Methods A multicentred, prospective observational study was undertaken during April 2020 to identify adults treated for acute appendicitis. Searches of operative and radiological records were performed to identify patients treated during April 2018 and April 2019 for comparison. Results A total of 190 patients were treated for acute appendicitis pre-lockdown compared with 64 patients treated during lockdown. Patients treated during the pandemic were more likely to have a higher American Society of Anesthesiology (ASA) score (p = 0.049) and to have delayed their presentation to hospital (2 versus 3 days, p = 0.03). During the lockdown, the use of computed tomography (CT) increased from 36.3% to 85.9% (p Conclusions The COVID-19 lockdown was associated with a decreased incidence of acute appendicitis and a significant shift in the management approach. The increased use of CT allows the identification of simple appendicitis for conservative treatment and decreases the negative appendicectomy rate. |
| Databáze: | OpenAIRE |
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