Observational studyLangenbeck's archives of surgery2021
Suspected appendicitis and COVID-19, a change in investigation and management-a multicentre cohort study.
Observational study in Langenbeck's archives of surgery, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 2 of them syntheses that pooled it.
What it found
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
21 citing papers in PubMed, 2 syntheses or guidelines pooled it, 42 citations in OpenAlex.
- SAGES guidelines update to laparoscopy in the era of COVID-19.Surgical endoscopy · 2025Guideline
- Rate of Application and Outcome of Non-operative Management of Acute Appendicitis in the Setting of COVID-19: Systematic Review and Meta-analysis.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2021Pooled it
- The rate of complicated appendicitis during a nonpharmaceutical intervention in two territories with different COVID-19 incidence.BMC gastroenterology · 2025Article
- Time to improve the management of patients with suspected acute appendicitis: a retrospective study.Abdominal radiology (New York) · 2024Article
- Indication of conservative treatment by antibiotics for uncomplicated and complicated acute appendicitis.World journal of gastrointestinal surgery · 2024Article
- Impact of the COVID-19 pandemic on the clinical management trends for acute appendicitis among the under-25s: a retrospective study.Archives of disease in childhood · 2024Article
- The impact of the COVID-19 pandemic on the number of patients presenting with appendicitis to the emergency department.Przeglad gastroenterologiczny · 2024Article
- Epidemiology and Outcome of Acute Appendicitis during and before the COVID-19 Pandemic: A Retrospective Single-Center Analysis.Medicina (Kaunas, Lithuania) · 2023Observational
- Has the frequency of complicated appendicitis changed in children in the first year of the COVID-19 pandemic?Annals of pediatric surgery · 2023Article
- Article
- Laparoscopic appendectomy for acute appendicitis in patients with COVID-19 confirmation: A case report.International journal of surgery case reports · 2022Article
- Changes in hospital admissions and complications of acute appendicitis during the COVID-19 pandemic: A systematic review and meta-analysis.Health sciences review (Oxford, England) · 2022Review
- Multicenter cohort study on the presentation and treatment of acute appendicitis during the COVID-19 pandemic.International journal of colorectal disease · 2022Article
- Impact of the COVID-19 pandemic on subcutaneous venous port-related complications in patients with cancer: a retrospective case-control study.World journal of surgical oncology · 2022Article
- COVID-19 pandemic changed the management and outcomes of acute appendicitis in northern Beijing: A single-center study.World journal of clinical cases · 2022Article
- Article
- Suspected and Confirmed Acute Appendicitis During the COVID-19 Pandemic: First and Second Quarantines-a Prospective Study.Frontiers in surgery · 2022Article
- A concise pathophysiological model of acute appendicitis against the background of the COVID-19 pandemic.Frontiers in pediatrics · 2022Review
- The Impact of the COVID-19 Pandemic on the Incidence, Severity, and Management of Acute Appendicitis: A Single Center Experience in Thailand.Emergency medicine international · 2022Article
- Appendectomy during the COVID-19 pandemic in Italy: a multicenter ambispective cohort study by the Italian Society of Endoscopic Surgery and new technologies (the CRAC study).Updates in surgery · 2021Observational
Corrections and comments
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Authors and funding
10 authors at 5 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeThe COVID-19 pandemic has reformed global healthcare delivery. On 25 March 2020, Intercollegiate guidelines were published in the UK to promote safe surgical provision during the COVID-19 outbreak advocating non-operative management or avoidance of laparoscopy when surgery is essential. The effects of this on the investigation and management of appendicitis remain unknown.
methodsWe performed a multicentre, prospective, observational study from the start of the new guidelines to the 6th of May 2020. We included all patients referred to surgical teams with suspected appendicitis. A recent historical cohort was identified for comparison. The primary outcome was the impact of the COVID-19 pandemic on the use of non-operative management in appendicitis. Secondary outcomes included imaging, negative appendicectomy rate (NAR), length of stay (LOS) and 30-day complications.
resultsA total of 63/164 (38%) patients compared to 79/191 (41%) were diagnosed with appendicitis before and after the guidelines were introduced (p = 0.589). CT scanning increased (71/164 vs 105/191; p = 0.033) while ultrasound scanning decreased (71/164 vs 62/191; p = 0.037). Appendicitis was more likely to be managed non-operatively (11/63 vs 51/79; p < 0.001) and, of those managed surgically, with an open approach (3/52 vs 26/28 p < 0.001). The NAR also reduced (5/52 vs 0/28; p = 0.157). LOS was shorter in non-operatively managed patients (1 day vs 3 days; p < 0.001) without a difference in complications (10/51 vs 4/28; p = 0.760).
conclusionIntroduction of the guidelines was associated with changes in practice. Despite these changes, short-term complications did not increase and LOS decreased. Questions remain on the longer-term complication rates in non-operatively managed patients.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.