Surgical management of acute appendicitis during the European COVID-19 second wave : safe and effective
© 2022. The Author(s)..
INTRODUCTION: The COVID-19 (SARS-CoV-2) pandemic drove acute care surgeons to pivot from long established practice patterns. Early safety concerns regarding increased postoperative complication risk in those with active COVID infection promoted antibiotic-driven non-operative therapy for select conditions ahead of an evidence-base. Our study assesses whether active or recent SARS-CoV-2 positivity increases hospital length of stay (LOS) or postoperative complications following appendectomy.
METHODS: Data were derived from the prospective multi-institutional observational SnapAppy cohort study. This preplanned data analysis assessed consecutive patients aged ≥ 15 years who underwent appendectomy for appendicitis (November 2020-May 2021). Patients were categorized based on SARS-CoV-2 seropositivity: no infection, active infection, and prior infection. Appendectomy method, LOS, and complications were abstracted. The association between SARS-CoV-2 seropositivity and complications was determined using Poisson regression, while the association with LOS was calculated using a quantile regression model.
RESULTS: Appendectomy for acute appendicitis was performed in 4047 patients during the second and third European COVID waves. The majority were SARS-CoV-2 uninfected (3861, 95.4%), while 70 (1.7%) were acutely SARS-CoV-2 positive, and 116 (2.8%) reported prior SARS-CoV-2 infection. After confounder adjustment, there was no statistically significant association between SARS-CoV-2 seropositivity and LOS, any complication, or severe complications.
CONCLUSION: During sequential SARS-CoV-2 infection waves, neither active nor prior SARS-CoV-2 infection was associated with prolonged hospital LOS or postoperative complication. Despite early concerns regarding postoperative safety and outcome during active SARS-CoV-2 infection, no such association was noted for those with appendicitis who underwent operative management.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:49 |
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| Enthalten in: |
European journal of trauma and emergency surgery : official publication of the European Trauma Society - 49(2023), 1 vom: 19. Feb., Seite 57-67 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Forssten, Maximilian Peter [VerfasserIn] |
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| Links: |
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| Themen: |
Acute appendicitis |
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| Anmerkungen: |
Date Completed 20.02.2023 Date Revised 20.02.2023 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1007/s00068-022-02149-w |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM351690654 |
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| 100 | 1 | |a Forssten, Maximilian Peter |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Surgical management of acute appendicitis during the European COVID-19 second wave |b safe and effective |
| 264 | 1 | |c 2023 | |
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| 500 | |a Date Completed 20.02.2023 | ||
| 500 | |a Date Revised 20.02.2023 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © 2022. The Author(s). | ||
| 520 | |a INTRODUCTION: The COVID-19 (SARS-CoV-2) pandemic drove acute care surgeons to pivot from long established practice patterns. Early safety concerns regarding increased postoperative complication risk in those with active COVID infection promoted antibiotic-driven non-operative therapy for select conditions ahead of an evidence-base. Our study assesses whether active or recent SARS-CoV-2 positivity increases hospital length of stay (LOS) or postoperative complications following appendectomy | ||
| 520 | |a METHODS: Data were derived from the prospective multi-institutional observational SnapAppy cohort study. This preplanned data analysis assessed consecutive patients aged ≥ 15 years who underwent appendectomy for appendicitis (November 2020-May 2021). Patients were categorized based on SARS-CoV-2 seropositivity: no infection, active infection, and prior infection. Appendectomy method, LOS, and complications were abstracted. The association between SARS-CoV-2 seropositivity and complications was determined using Poisson regression, while the association with LOS was calculated using a quantile regression model | ||
| 520 | |a RESULTS: Appendectomy for acute appendicitis was performed in 4047 patients during the second and third European COVID waves. The majority were SARS-CoV-2 uninfected (3861, 95.4%), while 70 (1.7%) were acutely SARS-CoV-2 positive, and 116 (2.8%) reported prior SARS-CoV-2 infection. After confounder adjustment, there was no statistically significant association between SARS-CoV-2 seropositivity and LOS, any complication, or severe complications | ||
| 520 | |a CONCLUSION: During sequential SARS-CoV-2 infection waves, neither active nor prior SARS-CoV-2 infection was associated with prolonged hospital LOS or postoperative complication. Despite early concerns regarding postoperative safety and outcome during active SARS-CoV-2 infection, no such association was noted for those with appendicitis who underwent operative management | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Observational Study | |
| 650 | 4 | |a Acute appendicitis | |
| 650 | 4 | |a Appendectomy | |
| 650 | 4 | |a COVID-19 | |
| 650 | 4 | |a Observational cohort | |
| 650 | 4 | |a Outcomes | |
| 700 | 1 | |a Kaplan, Lewis J |e verfasserin |4 aut | |
| 700 | 1 | |a Tolonen, Matti |e verfasserin |4 aut | |
| 700 | 1 | |a Martinez-Casas, Isidro |e verfasserin |4 aut | |
| 700 | 1 | |a Cao, Yang |e verfasserin |4 aut | |
| 700 | 1 | |a Walsh, Thomas N |e verfasserin |4 aut | |
| 700 | 1 | |a Bass, Gary Alan |e verfasserin |4 aut | |
| 700 | 1 | |a Mohseni, Shahin |e verfasserin |4 aut | |
| 700 | 0 | |a ESTES SnapAppy Group |e verfasserin |4 aut | |
| 700 | 1 | |a Ahl Hulme, Rebecka |e investigator |4 oth | |
| 700 | 1 | |a Biloslavo, Alan |e investigator |4 oth | |
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| 700 | 1 | |a Mäkäräinen-Uhlbäck, Elisa J |e investigator |4 oth | |
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