ACUTE APPENDICITIS OR NEGATIVE APPENDECTOMY? WHICH WAS REDUCED DURING THE COVID-19 PANDEMIC?

Year 2023, , 492 - 498, 23.09.2023

Metin Yalaza , Betül Keskinkılıç Yağız , Serdar Coşkun

https://doi.org/10.17343/sdutfd.1344052

Abstract

Objective
The restrictions and fear against the hospitals during
the pandemic has caused a reduction in the emergency
department admittance but it appears that patients
with various surgical conditions have admitted with an
advanced condition. The aim of the present study is to
evaluate and to compare disease severity at the time
of admittance and the negative appendectomy rates
among the patients who were operated for acute appendicitis
between the pandemic period and before
the pandemics.
Material and Method
The data of the 152 patients who were operated for
acute appendicitis during the first episode of restrictions
of the pandemics (03.12.2020-05.31.2020) and
1 year before the restrictions (03.12.2019-05.31.2019)
were retrospectively evaluated. The rates of appendectomy
and complicated appendicitis, appendiceal
diameter, inflammatory markers, diagnostic imaging
modalities and length of hospital stay were evaluated.
Results
The appendectomy rates were reduced in the pandemic
period by 41.6% compared to the previous period.
Leucocyste and neutrophile counts and appendiceal
diameter were significantly higher in the pandemic
period than the previous period (p=0.003, p=0.014,
p=0.013, respectively). No significant difference was
observed for length of hospital stay between the 2
periods. Although not statistically significant, CT was
more commonly performed (59.3% vs 73.3%) while
US was less commonly performed (40.7% vs. 26.7%)
in the pandemic period. The rates of non-complicated
appendicits and malignancy were not different between
the 2 periods (63.5% vs. 67.9% and 2.1% vs. 2.8%,
respectively). Although not statistically significant, the
rate of complicated appendicitis was increased (16.7%
vs. 23.2%) and the rate of negative appendicitis was
reduced (17.7% vs. 7.1%)
Conclusion
It is not possible to withdraw strong conclusions depending
on the current literature data regarding the
prepandemic and pandemic comparison of complicated
appendicitis and negative appendicitis. Pandemic
has caused a considerable impact on the appendicitis
severity at admission and management process.

Keywords

acute appendicitis, negative appendectomy, COVID-19

Project Number

Proje kapsamında destek alınmamış bir çalışmadır

COVİD-19 PANDEMİ DÖNEMİNDE AKUT APANDİSİT Mİ, NEGATİF APENDEKTOMİ Mİ AZALDI?

Abstract

Amaç
Pandemi döneminde hastanelerden duyulan korku ve
kısıtlamalar acil serviste hasta başvurularını önemli ölçüde
azaltırken çeşitli cerrahi hastalıkların ciddiyetinde
kayda değer bir artışına neden olmuştur. Çalışmamızda
ameliyat edilen akut apandisit olgularının başvuru
anındaki hastalık ciddiyetini ve negatif apendektomi
oranlarını belirleyerek bu sonuçları pandemi olmayan
dönemle karşılaştırmayı amaçladık.
Gereç ve Yöntem
Pandemi döneminde (12.03.2020- 31.05.2020) ve
pandemi olmayan dönemde (12.03.2019-31.05.2019)
apandisit nedeniyle tedavi edilen 152 hastanın verileri
geriye dönük olarak incelendi. Apendektomi sayıları,
komplike akut apandisit oranları, apandiks çapları, inflamatuar
belirteçler, tanısal amaçla tercih edilen görüntüleme
yöntemleri ve hastaların hastanede yatış
süreleri ile ilgili veriler analiz edildi.
Bulgular
Pandemi döneminde bir önceki yılın aynı zaman aralığına
kıyasla apendektomi sayısının %41,6 oranında
azaldığı tespit edildi. Pandemi döneminde lökosit ve
nötrofil sayısı ve apendiks çapının pandemi olmayan
döneme göre anlamlı oranda arttığı izlendi (sırasıyla
p=0.003,p=0.014,p=0,013). Her iki dönemde hastanede
yatış süreleri açısından anlamlı farklılık izlenmedi.
Pandemi döneminde anlamlı oranda olmasada bilgisayarlı
tomografi kullanımının arttığı (%59,3’e karşı
%73,3) ve USG kullanımının azaldığı (%40,7’ye karşı
%26,7) tespit edildi. Komplike olmayan akut apandisit
ve malignite oranlarının her iki dönemde benzer olduğu
izlendi (sırasıyla %63,5, %67,9 ve %2,1, %1,8).
Pandemi döneminde anlamlı oranda olmamakla birlikte
komplike apandisit oranının arttığı (%16,7’ye karşı
%23,2) ve negatif apendektomi oranının azaldığı
(%17,7’ye karşı %7,1) izlendi.
Sonuç
Pandemi öncesi dönemle kıyaslandığında komplike
apandisit ve negatif apendektomi oranlarında tespit
ettiğimiz ancak istatistiksel olmayan farkla ilgili mevcut
literatürden kesin hüküm çıkarmak mümkün değildir.
Pandemi apandisitin tanı zamanının yanı sıra seyrini
ve tedavi yaklaşımını de etkilemiştir.

Keywords

COVİD-19, akut apandisit, negatif apendektomi

Supporting Institution

herhangi bir mali destek alınmamıştır

Project Number

Proje kapsamında destek alınmamış bir çalışmadır

Thanks

Zaman ayırdığınız ve değerlendirdiğiniz için teşekkür ediyorum

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