Covid-19 pandemisi daha komplike akut apandisit olgularına mı yol açtı ?

Year 2022, Volume: 13 Issue: 2, 227 - 231, 30.06.2022

Alpaslan Şahin , Ersin Turan

https://doi.org/10.18663/tjcl.1120997

Cited By: 1

Abstract

Amaç:Covid-19 salgınında, hastaların hastaneye başvuruları kontaminasyon endişeleri nedeniyle ertelendi. Çalışmamız pandemi sürecinde akut apandisit (AA) nedeniyle tedavi gören hastalarda hastaneye yatış süresi, komplike AA oranı ve komplikasyon oranlarını belirlemeyi ve bunları pandemi olmayan dönemle karşılaştırmayı amaçladı.
Gereç ve Yöntemler:Pandemi döneminde (11.03.2020 - 01.06.2020) ve pandemi olmayan dönemde (11.03.2019-01.06.2019) apandisit nedeniyle tedavi edilen 159 hastanın verileri geriye dönük olarak incelendi. Başvuru süresi, komplike AA oranı, inflamatuar belirteçler, hastanede kalış süresi, postoperatif komplikasyonlar ve dren kullanımı ile ilgili veriler analiz edildi.
Bulgular: Ortalama hastaneye başvuru süresi grup 1'de 1,37 ± 1,53 gün, grup 2'de 2,54 ± 2,18 gündü (p <0,05). CRP değerleri grup 2'de anlamlı olarak yüksekti (p <0.05). USG ile değerlendirilen komplike AA oranı grup 2'de %30 (12), grup 1'de %11,45 (6) idi (p <0,05). İntraoperatif Komplike AA oranı grup 1'de %6,9 (6), grup 2'de %18,06 (13) idi (p <0,05). Laparoskopik apendektomi oranı grup 1'de%33,3 (29), grup 2'de %12,5 (9) idi (p <0,05). Hastanede kalış süreleri (gün) karşılaştırıldığında, grup 2'de hastanede kalış süresi daha yüksekti (p <0.05).
Sonuçlar:Pandemi döneminde hastaneye geç başvuru nedeniyle komplike AA oranı artmaktadır.

Keywords

akut apandisit;, covid-19, acil cerrahi

Supporting Institution

yok

Project Number

-

Thanks

Çalışmanın fikir aşamasında desteğinden dolayı Op.Dr.Gürcan Şimşek'e teşekkürlerimizi sunarız

Did Covid-19 pandemic increase the rate of complicated acute appendicitis?

Abstract

Aim: In the Covid-19 pandemic, patients' admissions to the hospital were delayed for concerns of contamination. Our study aimed to determine the duration of admission to hospital, complicated AA rate, and complication rates in patients treated for acute appendicitis (AA) during the pandemic process and compare them with the non-pandemic period.
Material and Methods: Data of 159 patients treated for appendicitis during the pandemic period (11.03.2020 - 01.06.2020) and non-pandemic period (11.03.2019-01.06.2019) were analyzed retrospectively. Data on admission time, complicated AA rate, inflammatory markers, hospitalization time, postoperative complications, and drain usage were analyzed.
Results: The hospital's average admission time was 1.37 ± 1.53 days in group 1 and 2.54 ± 2.18 days in group 2 (p <0.05). CRP values were significantly higher in group 2 (p <0.05). The complicated AA rate of patients evaluated by USG in group 2 was 30% (12), and in group 1, 11.45% (6)(p <0.05). Intraoperative Complicated AA rate was 6.9% (6) in group 1 and 18.06% (13) in group 2 (p <0.05). Laparoscopic appendectomy rate was 33.3% (29) in group 1 and 12.5% (9) in group 2 (p <0.05). When hospitalization periods (days) were compared, the duration of hospitalization was higher in group 2 (p <0.05).
Conclusion: During the pandemic period, complicated AA rate increases due to late admission to the hospital.

Keywords

acute appendicitis;, covid-19;, emergency surgery

Project Number

-

References

• 1. Cervellin G, Mora R, Ticinesi A et al. Epidemiology and outcomes of acute abdominal pain in a Large Urban Emergency Department: retrospective analysis of 5,340 cases. Ann Transl Med 2016; 4: 362.
• 2. Viniol A, Keunecke C, Biroga T et al. Studies of the symptom abdominal pain--a systematic review and meta-analysis. Fam Pract 2014; 31: 517–29.
• 3. Flum DR. Acute Appendicitis — Appendectomy or the “Antibiotics First” Strategy. N Engl J Med 2015; 372: 1937–43.
• 4. Senekjian L, Nirula R, Bellows B et al. Interval appendectomy: finding the breaking point for cost-effectiveness. J Am Coll Surg 2016; 223: 632–43.
• 5. Andersen KG, Rambaut A, Lipkin WI, Holmes EC, Garry RF. The proximal origin of SARS-CoV-2. Nat Med 2020; 26: 450-2.
• 6. Wu Z, McGoogan JM (2020) Characteristics of and important lessons from the coronavirus disease 2019 (COVID-19) outbreak in China. JAMA 2020; 323: 1239-42.
• 7. Di Saverio S, Podda M, De Simone B et al. Diagnosis and treatment of acute appendicitis: 2020 update of the WSES Jerusalem guidelines. World J Emerg Surg 2020; 15:27.
• 8. Elniel M, Grainger J, Nevins EJ et al. 72 h Is the time critical point to operate in acute appendicitis. J Gastrointest Surg 2018; 22: 310–5.
• 9. M. Velayos, A.J. Mu˜noz-Serrano, K. Estefanía-Fernández et al. Influence of the coronavirus 2 (SARS-Cov-2) pandemicon acute appendicitis. An Pediatr (Engl Ed) 202; 93: 118–22.
• 10. Rud B, Olafsson L, Vejborg T et al. Diagnostic accuracy of computed tomography for appendicitis in adults.Cochrane Database Syst Rev 2019; 11: 9977
• 11. Akbulut S, Koç C, Şahin TT et al. An investigation into the factors predicting acute appendicitis and perforated appendicitis. Ulus Travma Acil Cerrahi Derg 2021; 27: 434-42.
• 12. Gaskill CE, Simianu VV, Carnell J et al. Use of computed tomography to determine perforation in patients with acute appendicitis. Curr Prob Diagnostic Radiol 2018; 47: 6–9.
• 13. Bani Hani DA, Alsharaydeh I, Bataineh AM, et al. Successful Anesthetic Management in Cesarean Section for Pregnant Woman with COVID-19. Am J Case Rep 2020; 21: 925512.
• 14. Baral, Suman, Rajkumar Chhetri, and Neeraj Thapa. Comparison of Acute Appendicitis Before and Within COVID 19 Era: A Retrospective Study from Rural Nepal. Plos One 2021; 16: 245137.