Is the COVID-19 Pandemic Causing Delays in the Diagnosis of Appendicitis in Children?

Öz

Objective: We aimed to investigate whether there is an increase in the number of complicated appendicitis during pandemic period.

Material and Methods: Data of patients were evaluated retrospectively. Patients were divided into two-groups as pre-pandemic and pandemic. Age, gender, duration after the onset of complaints until visiting hospital, WBC count, days after presentation to hospital until surgery, surgical method, whether the appendix was complicated, duration of hospitalization, whether any complications developed, and results of PCR tests were evaluated. The data of the groups were compared and it was investigated whether there was any difference between them. Statistical analysis was done with the SPSS (Statistical Package for Social Sciences) version 21. P < 0.05 was considered significant.

Results: Appendectomy was performed in 327 patients during pandemic and in 295 during pre-pandemic period. Although the ratio of complicated appendicitis increased during pandemic compared to pre-pandemic period (47.1% versus 40.7%), there was no difference between groups. However, duration between onset of symptoms and arrival at hospital (p=0.003), time elapsed before surgery (p=0.021), length-of-stay in hospital (p=0.009), and developed complications (p=0.01) were higher in pandemic group.

Conclusion: Comparing prepandemic, although there was no statistically significant difference during the pandemic period, there was an increase in complicated appendicitis and related complications. It was attributed to late arrival at hospitals due to curfews, parental fear of disease transmission, and prolonged duration of screening tests in the emergency departments.

Anahtar Kelimeler

• COVID-19 pandemic
• parental fair
• children
• acute appendicitis
• complicated appendicitis
• perforated appendicitis

COVID-19 Pandemisi Çocuklarda Apandisit Tanısının Konulmasında Gecikmelere Neden Oluyor mu?

Öz

Amaç: Çalışmamızın amacı COVID-19 pandemisi sırasında komplike apandisit sayısında artış olup olmadığını araştırmaktır.

Gereç ve Yöntemler: Hastalar COVID-19 pandemisinin başladığı tarih esas alınarak, başvuru tarihlerine göre pre-pandemi ve pandemi grubu olmak üzere iki gruba ayrıldı ve verileri retrospektif olarak tarandı. Yaş, cinsiyet, şikayetlerin başlangıcından hastaneye gelene kadar geçen süre, WBC sayısı, hastaneye başvurudan ameliyat olana kadar geçen süre, uygulanan cerrahi yöntem, ameliyat esnasında apendiksin komplike olup olmadığı, hastanede kalış süreleri, komplikasyon gelişip gelişmediği ve PCR testlerinin sonuçları araştırıldı. Grupların verileri karşılaştırılarak aralarında fark olup olmadığı araştırıldı. İstatistiksel analiz SPSS (Statistical Package for Social Sciences) version 21 programı ile yapıldı. Tüm değişkenler için p <0.05 anlamlı kabul edildi.

Bulgular: Covid-19 pandemisi sırasında 327 hastaya, pandemi öncesi dönemde ise 295 hastaya apendektomi yapıldı. Pandemi sırasında komplike apandisit oranı pandemi öncesi döneme göre artmasına rağmen (%47.1’e karşı %40.7) gruplar arasında istatistiksel olarak fark bulunmadı. Ancak pre-pandemi grubu ile kıyaslandığında, pandemi grubunda semptomların başlangıcı ile hastaneye varış arasındaki süre (p = 0.003), ameliyattan önce geçen süre (p = 0.021), hastanede kalış süresi (p = 0.009) ve gelişen komplikasyonlar (p = 0.01) daha yüksek bulundu.

Sonuç: Pre-pandemi grubu ile kıyaslandığında, aralarında istatistiksel olarak fark tespit edilmemekle birlikte, Pandemi döneminde komplike apandisit ve buna bağlı komplikasyonlarda artış tespit edildi. Bu artış sokağa çıkma yasakları nedeniyle hastanelere geç başvurulması, ebeveynlerin bulaş korkusu ve acil servislerde tarama testlerinin uzun sürmesi ile ilişkilendirildi.

Anahtar Kelimeler

• COVID-19 pandemisi
• ebeveynlerin bulaş korkusu
• çocuk
• akut apandisit
• komplike apandisit
• perfore apandisit

Kaynakça

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