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Comparative Analysis of Acute Appendicitis Cases During and Prior to the Pandemic

Year 2024, Volume: 15 Issue: 2, 162 - 168, 01.07.2024
https://doi.org/10.18663/tjcl.1427267

Abstract

Aim: This study aimed to compare the clinical characteristics, morbidity, and diagnostic accuracy of imaging modalities in acute appendicitis cases during the COVID-19 pandemic and the pre-pandemic period.
Materials and Methods: We retrospectively analyzed the records of 898 patients who underwent surgery for acute appendicitis between April 2019 and April 2021. The study population was divided into two groups: pre-pandemic (n=508; April 2019 to April 2020) and pandemic (n=390; April 2020 to April 2021). We compared the socio-demographic characteristics, clinical features, morbidity rates, and the diagnostic accuracy of ultrasonography (USG) and computed tomography (CT) between the two periods.
Results: The prevalence of complicated cases was significantly higher during the pre-pandemic period (29.3%) compared to the pandemic period (15.6%). The morbidity rate was also significantly higher in the pre-pandemic period. ( p= 0,004) The sensitivity of USG in diagnosing appendicitis decreased during the pandemic period, while CT scans remained more sensitive than USG in both periods. (sensitivity = 0.93, specificity = 0,67) The prevalence of chronic diseases was significantly higher during the pandemic period.
Conclusion: Our study revealed that the prevalence of complicated appendicitis cases was significantly higher during the pre-pandemic period compared to the pandemic period. Additionally, the sensitivity of ultrasonography in diagnosing appendicitis decreased during the pandemic, while CT scans maintained their sensitivity across both periods. Based on our findings, we can confidently conclude that the pandemic does not exacerbate the severity of acute appendicitis cases.

References

  • Baird DLH, Simillis C, Kontovounisios C, Rasheed S, Tekkis PP: Acute appendicitis. Bmj 2017, 357:j1703.
  • Humes DJ, Simpson J: Acute appendicitis. Bmj 2006, 333(7567):530-534.
  • Addiss DG, Shaffer N, Fowler BS, Tauxe RV: The epidemiology of appendicitis and appendectomy in the United States. Am J Epidemiol 1990, 132(5):910-925.
  • Chang YJ, Chen LJ, Chang YJ: Did the severity of appendicitis increase during the COVID-19 pandemic? PLoS One 2022, 17(2):e0263814.
  • Ucar Karabulut K, Erinanc H, Yonar A, Kisinma A, Ucar Y: Correlation of histological diagnosis and laboratory findings in distinguishing acute appendicitis and lymphoid hyperplasia. Ann Surg Treat Res 2022, 103(5):306-311.
  • Romero J, Valencia S, Guerrero A: Acute Appendicitis During Coronavirus Disease 2019 (COVID-19): Changes in Clinical Presentation and CT Findings. J Am Coll Radiol 2020, 17(8):1011-1013.
  • Tankel J, Keinan A, Blich O, Koussa M, Helou B, Shay S et al: The Decreasing Incidence of Acute Appendicitis During COVID-19: A Retrospective Multi-centre Study. World J Surg 2020, 44(8):2458-2463.
  • Lee-Archer P, Blackall S, Campbell H, Boyd D, Patel B, McBride C: Increased incidence of complicated appendicitis during the COVID-19 pandemic. J Paediatr Child Health 2020, 56(8):1313-1314.
  • Orthopoulos G, Santone E, Izzo F, Tirabassi M, Pérez-Caraballo AM, Corriveau N et al: Increasing incidence of complicated appendicitis during COVID-19 pandemic. Am J Surg 2021, 221(5):1056-1060.
  • Köhler F, Müller S, Hendricks A, Kastner C, Reese L, Boerner K et al: Changes in appendicitis treatment during the COVID-19 pandemic - A systematic review and meta-analysis. Int J Surg 2021, 95:106148.
  • Sohrabi C, Alsafi Z, O'Neill N, Khan M, Kerwan A, Al-Jabir A et al: World Health Organization declares global emergency: A review of the 2019 novel coronavirus (COVID-19). Int J Surg 2020, 76:71-76.
  • Flemming S, Hankir M, Ernestus RI, Seyfried F, Germer CT, Meybohm P et al: Surgery in times of COVID-19-recommendations for hospital and patient management. Langenbecks Arch Surg 2020, 405(3):359-364.
  • Ocak S, Bük Ö F, Uyanık MS, Çiftci AB: COVID-19 outbreak and acute appendicitis: Does the lockdown has a influence on appendectomies?-A single center retrospective cohort study. Turk J Surg 2022, 38(2):175-179.
  • Ganesh R, Lucocq J, Ekpete NO, Ain NU, Lim SK, Alwash A et al: Management of appendicitis during COVID-19 pandemic; short-term outcomes. Scott Med J 2020, 65(4):144-148.
  • Dreifuss NH, Schlottmann F, Sadava EE, Rotholtz NA: Acute appendicitis does not quarantine: surgical outcomes of laparoscopic appendectomy in COVID-19 times. Br J Surg 2020, 107(10):e368-e369.
  • Willms AG, Oldhafer KJ, Conze S, Thasler WE, von Schassen C, Hauer T et al: Appendicitis during the COVID-19 lockdown: results of a multicenter analysis in Germany. Langenbecks Arch Surg 2021, 406(2):367-375.
  • Serrano-González SP, Nájera-Reyes JA, Ortiz-Mendoza CM: Changing characteristics of emergency surgery during COVID-19 pandemic: a retrospective cohort study. Cir Cir 2022, 90(S2):13-17.
  • Kupietzky A, Finkin M, Dover R, Eliezer Lourie NE, Mordechai-Heyn T, Juster EY et al: Higher Rates of Complicated Appendicitis During the COVID-19 Pandemic: A Year-to-Year Analysis. J Surg Res 2023, 290:304-309.
  • Wang AW, MD, Prieto J, MD, Ikeda DS, MD, Lewis PR, DO, Benzer EM, DO, Van Gent J-M, DO, FACS: Perforated Appendicitis: An Unintended Consequence During the Coronavirus-19 Pandemic. Military Medicine 2021, 186(1-2):e94-e97.
  • Burgard M, Cherbanyk F, Nassiopoulos K, Malekzadeh S, Pugin F, Egger B: An effect of the COVID-19 pandemic: Significantly more complicated appendicitis due to delayed presentation of patients! PLoS One 2021, 16(5):e0249171.
  • Köhler F, Müller S, Hendricks A, Kastner C, Reese L, Boerner K et al: Changes in appendicitis treatment during the COVID-19 pandemic – A systematic review and meta-analysis. International Journal of Surgery 2021, 95:106148.
  • Won M, Ahn C: Epidemiology and Outcome of Acute Appendicitis during and before the COVID-19 Pandemic: A Retrospective Single-Center Analysis. Medicina (Kaunas) 2023, 59(5).
  • Başkent A, Alkan M, Başkent MF: The effect of COVID-19 pandemic period on acute appendicitis and its complications. Ulus Travma Acil Cerrahi Derg 2022, 29(1):40-45.
  • Ceresoli M, Coccolini F, Magnone S, Lucianetti A, Bisagni P, Armao T et al: The decrease of non-complicated acute appendicitis and the negative appendectomy rate during pandemic. Eur J Trauma Emerg Surg 2021, 47(5):1359-1365.
  • Antakia R, Xanthis A, Georgiades F, Hudson V, Ashcroft J, Rooney S et al: Acute appendicitis management during the COVID-19 pandemic: A prospective cohort study from a large UK centre. Int J Surg 2021, 86:32-37.
  • Camino-Carrasco E, Fernandez-Guzman D, Caira-Chuquineyra B, Hermoza-Rosell R, Auccacusi-Rodriguez J, Pinares-Carrillo D: Differences in the evolution and management of acute appendicitis in patients with COVID-19: a case-control study. Cir Cir 2022, 90(6):742-748.

Pandemi Dönemi ve Öncesinde Akut Apandisit Olgularının Karşılaştırmalı Analizi

Year 2024, Volume: 15 Issue: 2, 162 - 168, 01.07.2024
https://doi.org/10.18663/tjcl.1427267

Abstract

Amaç: Bu çalışma, COVID-19 pandemisi sırasında ve pandemi öncesi dönemde akut apandisit vakalarında klinik özellikler, morbidite ve görüntüleme yöntemlerinin tanısal doğruluğunu karşılaştırmayı amaçlamıştır.
Yöntem: Nisan 2019 ile Nisan 2021 arasında akut apandisit nedeniyle ameliyat olan 898 hastanın kayıtları retrospektif olarak analiz edilmiştir. Çalışma popülasyonu iki gruba ayrılmıştır: pandemi öncesi (n=508; Nisan 2019 - Nisan 2020) ve pandemi (n=390; Nisan 2020 - Nisan 2021). İki dönem arasında sosyodemografik özellikler, klinik özellikler, morbidite oranları ve ultrasonografi (USG) ile bilgisayarlı tomografi (BT) tanısal doğruluğu karşılaştırılmıştır.
Bulgular: Komplike vakaların prevalansı, pandemi öncesi dönemde (%29.3) pandemi dönemine (%15.6) göre anlamlı olarak daha yüksekti. Morbidite oranı da pandemi öncesi dönemde anlamlı olarak daha yüksekti. ( p= 0,004) USG'nin apandisiti teşhis etmedeki duyarlılığı pandemi döneminde azalmış, ancak BT taramaları her iki dönemde de USG'den daha duyarlı kalmıştır ( sensivite = 0.93, spesifite = 0,67) . Kronik hastalıkların prevalansı pandemi döneminde anlamlı olarak daha yüksekti.
Sonuç: Çalışmamız, komplike apandisit vakalarının prevalansının pandemi öncesi döneme göre pandemi döneminde anlamlı olarak daha düşük olduğunu ortaya koymuştur. Ayrıca, apandisiti teşhis etmede ultrasonografinin duyarlılığı pandemi döneminde azalmış, ancak BT taramaları her iki dönemde de duyarlılıklarını korumuştur. Çalışmamızın sonuçlarına dayanarak, pandemi döneminde apandisit vakalarının daha komplike hale gelmediğini ifade edebiliriz.

References

  • Baird DLH, Simillis C, Kontovounisios C, Rasheed S, Tekkis PP: Acute appendicitis. Bmj 2017, 357:j1703.
  • Humes DJ, Simpson J: Acute appendicitis. Bmj 2006, 333(7567):530-534.
  • Addiss DG, Shaffer N, Fowler BS, Tauxe RV: The epidemiology of appendicitis and appendectomy in the United States. Am J Epidemiol 1990, 132(5):910-925.
  • Chang YJ, Chen LJ, Chang YJ: Did the severity of appendicitis increase during the COVID-19 pandemic? PLoS One 2022, 17(2):e0263814.
  • Ucar Karabulut K, Erinanc H, Yonar A, Kisinma A, Ucar Y: Correlation of histological diagnosis and laboratory findings in distinguishing acute appendicitis and lymphoid hyperplasia. Ann Surg Treat Res 2022, 103(5):306-311.
  • Romero J, Valencia S, Guerrero A: Acute Appendicitis During Coronavirus Disease 2019 (COVID-19): Changes in Clinical Presentation and CT Findings. J Am Coll Radiol 2020, 17(8):1011-1013.
  • Tankel J, Keinan A, Blich O, Koussa M, Helou B, Shay S et al: The Decreasing Incidence of Acute Appendicitis During COVID-19: A Retrospective Multi-centre Study. World J Surg 2020, 44(8):2458-2463.
  • Lee-Archer P, Blackall S, Campbell H, Boyd D, Patel B, McBride C: Increased incidence of complicated appendicitis during the COVID-19 pandemic. J Paediatr Child Health 2020, 56(8):1313-1314.
  • Orthopoulos G, Santone E, Izzo F, Tirabassi M, Pérez-Caraballo AM, Corriveau N et al: Increasing incidence of complicated appendicitis during COVID-19 pandemic. Am J Surg 2021, 221(5):1056-1060.
  • Köhler F, Müller S, Hendricks A, Kastner C, Reese L, Boerner K et al: Changes in appendicitis treatment during the COVID-19 pandemic - A systematic review and meta-analysis. Int J Surg 2021, 95:106148.
  • Sohrabi C, Alsafi Z, O'Neill N, Khan M, Kerwan A, Al-Jabir A et al: World Health Organization declares global emergency: A review of the 2019 novel coronavirus (COVID-19). Int J Surg 2020, 76:71-76.
  • Flemming S, Hankir M, Ernestus RI, Seyfried F, Germer CT, Meybohm P et al: Surgery in times of COVID-19-recommendations for hospital and patient management. Langenbecks Arch Surg 2020, 405(3):359-364.
  • Ocak S, Bük Ö F, Uyanık MS, Çiftci AB: COVID-19 outbreak and acute appendicitis: Does the lockdown has a influence on appendectomies?-A single center retrospective cohort study. Turk J Surg 2022, 38(2):175-179.
  • Ganesh R, Lucocq J, Ekpete NO, Ain NU, Lim SK, Alwash A et al: Management of appendicitis during COVID-19 pandemic; short-term outcomes. Scott Med J 2020, 65(4):144-148.
  • Dreifuss NH, Schlottmann F, Sadava EE, Rotholtz NA: Acute appendicitis does not quarantine: surgical outcomes of laparoscopic appendectomy in COVID-19 times. Br J Surg 2020, 107(10):e368-e369.
  • Willms AG, Oldhafer KJ, Conze S, Thasler WE, von Schassen C, Hauer T et al: Appendicitis during the COVID-19 lockdown: results of a multicenter analysis in Germany. Langenbecks Arch Surg 2021, 406(2):367-375.
  • Serrano-González SP, Nájera-Reyes JA, Ortiz-Mendoza CM: Changing characteristics of emergency surgery during COVID-19 pandemic: a retrospective cohort study. Cir Cir 2022, 90(S2):13-17.
  • Kupietzky A, Finkin M, Dover R, Eliezer Lourie NE, Mordechai-Heyn T, Juster EY et al: Higher Rates of Complicated Appendicitis During the COVID-19 Pandemic: A Year-to-Year Analysis. J Surg Res 2023, 290:304-309.
  • Wang AW, MD, Prieto J, MD, Ikeda DS, MD, Lewis PR, DO, Benzer EM, DO, Van Gent J-M, DO, FACS: Perforated Appendicitis: An Unintended Consequence During the Coronavirus-19 Pandemic. Military Medicine 2021, 186(1-2):e94-e97.
  • Burgard M, Cherbanyk F, Nassiopoulos K, Malekzadeh S, Pugin F, Egger B: An effect of the COVID-19 pandemic: Significantly more complicated appendicitis due to delayed presentation of patients! PLoS One 2021, 16(5):e0249171.
  • Köhler F, Müller S, Hendricks A, Kastner C, Reese L, Boerner K et al: Changes in appendicitis treatment during the COVID-19 pandemic – A systematic review and meta-analysis. International Journal of Surgery 2021, 95:106148.
  • Won M, Ahn C: Epidemiology and Outcome of Acute Appendicitis during and before the COVID-19 Pandemic: A Retrospective Single-Center Analysis. Medicina (Kaunas) 2023, 59(5).
  • Başkent A, Alkan M, Başkent MF: The effect of COVID-19 pandemic period on acute appendicitis and its complications. Ulus Travma Acil Cerrahi Derg 2022, 29(1):40-45.
  • Ceresoli M, Coccolini F, Magnone S, Lucianetti A, Bisagni P, Armao T et al: The decrease of non-complicated acute appendicitis and the negative appendectomy rate during pandemic. Eur J Trauma Emerg Surg 2021, 47(5):1359-1365.
  • Antakia R, Xanthis A, Georgiades F, Hudson V, Ashcroft J, Rooney S et al: Acute appendicitis management during the COVID-19 pandemic: A prospective cohort study from a large UK centre. Int J Surg 2021, 86:32-37.
  • Camino-Carrasco E, Fernandez-Guzman D, Caira-Chuquineyra B, Hermoza-Rosell R, Auccacusi-Rodriguez J, Pinares-Carrillo D: Differences in the evolution and management of acute appendicitis in patients with COVID-19: a case-control study. Cir Cir 2022, 90(6):742-748.
There are 26 citations in total.

Details

Primary Language English
Subjects General Surgery, Emergency Medicine
Journal Section Research Article
Authors

Oğuzhan Fatih Ay 0000-0002-0726-3968

Mehmet Akif Üstüner 0000-0003-4087-555X

Murat Can 0009-0008-2390-4033

Hikmet Haşemi 0009-0003-1022-231X

Burak Bilir 0000-0002-0012-9002

Publication Date July 1, 2024
Submission Date January 29, 2024
Acceptance Date June 12, 2024
Published in Issue Year 2024 Volume: 15 Issue: 2

Cite

APA Ay, O. F., Üstüner, M. A., Can, M., Haşemi, H., et al. (2024). Comparative Analysis of Acute Appendicitis Cases During and Prior to the Pandemic. Turkish Journal of Clinics and Laboratory, 15(2), 162-168. https://doi.org/10.18663/tjcl.1427267
AMA Ay OF, Üstüner MA, Can M, Haşemi H, Bilir B. Comparative Analysis of Acute Appendicitis Cases During and Prior to the Pandemic. TJCL. July 2024;15(2):162-168. doi:10.18663/tjcl.1427267
Chicago Ay, Oğuzhan Fatih, Mehmet Akif Üstüner, Murat Can, Hikmet Haşemi, and Burak Bilir. “Comparative Analysis of Acute Appendicitis Cases During and Prior to the Pandemic”. Turkish Journal of Clinics and Laboratory 15, no. 2 (July 2024): 162-68. https://doi.org/10.18663/tjcl.1427267.
EndNote Ay OF, Üstüner MA, Can M, Haşemi H, Bilir B (July 1, 2024) Comparative Analysis of Acute Appendicitis Cases During and Prior to the Pandemic. Turkish Journal of Clinics and Laboratory 15 2 162–168.
IEEE O. F. Ay, M. A. Üstüner, M. Can, H. Haşemi, and B. Bilir, “Comparative Analysis of Acute Appendicitis Cases During and Prior to the Pandemic”, TJCL, vol. 15, no. 2, pp. 162–168, 2024, doi: 10.18663/tjcl.1427267.
ISNAD Ay, Oğuzhan Fatih et al. “Comparative Analysis of Acute Appendicitis Cases During and Prior to the Pandemic”. Turkish Journal of Clinics and Laboratory 15/2 (July 2024), 162-168. https://doi.org/10.18663/tjcl.1427267.
JAMA Ay OF, Üstüner MA, Can M, Haşemi H, Bilir B. Comparative Analysis of Acute Appendicitis Cases During and Prior to the Pandemic. TJCL. 2024;15:162–168.
MLA Ay, Oğuzhan Fatih et al. “Comparative Analysis of Acute Appendicitis Cases During and Prior to the Pandemic”. Turkish Journal of Clinics and Laboratory, vol. 15, no. 2, 2024, pp. 162-8, doi:10.18663/tjcl.1427267.
Vancouver Ay OF, Üstüner MA, Can M, Haşemi H, Bilir B. Comparative Analysis of Acute Appendicitis Cases During and Prior to the Pandemic. TJCL. 2024;15(2):162-8.


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