ArticleSurgery2021
Where did the patients go? Changes in acute appendicitis presentation and severity of illness during the coronavirus disease 2019 pandemic: A retrospective cohort study.
Article in Surgery, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 32 papers, 2 of them syntheses that pooled it.
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Who cites it
32 citing papers in PubMed, 2 syntheses or guidelines pooled it, 48 citations in OpenAlex.
- Spontaneous Resolution of Uncomplicated Appendicitis may Explain Increase in Proportion of Complicated Appendicitis During Covid-19 Pandemic: a Systematic Review and Meta-analysis.World journal of surgery · 2023Pooled it
- Global burden of the COVID-19 associated patient-related delay in emergency healthcare: a panel of systematic review and meta-analyses.Globalization and health · 2022Pooled it
- Impact of Disease Severity and Age on Outcomes After Laparoscopic Versus Open Appendectomy: A Single-Center Retrospective Cohort Study.Life (Basel, Switzerland) · 2026Article
- Impact of the COVID-19 pandemic on the pattern of acute appendicitis, a single-center study.Frontiers in surgery · 2026Article
- Appendicitis.Nature reviews. Disease primers · 2025Review
- Impact of COVID-19 on acute appendicitis presentation, management and pathology findings in adult and paediatric populations.PloS one · 2024Article
- The impact of the COVID-19 pandemic on the number of patients presenting with appendicitis to the emergency department.Przeglad gastroenterologiczny · 2024Article
- Reasons for Delayed Diagnosis of Pediatric Acute Appendicitis during the COVID-19 Era: A Narrative Review.Diagnostics (Basel, Switzerland) · 2023Review
- Impact of the COVID-19 Pandemic on the Severity and Early Postoperative Outcomes of Acute Appendicitis.Cureus · 2023Article
- Acute Appendicitis During The COVID-19 Pandemic: A Multicenter, Retrospective Analysis From The US Epicenter.The American surgeon · 2023Article
- Impact of the Coronavirus (COVID-19) Pandemic on the Care of Pediatric Acute Appendicitis.The American surgeon · 2023Article
- Patients with appendicitis during COVID-19 pandemic: a retrospective cohort study.Annals of medicine and surgery (2012) · 2023Article
- Management of appendicitis: appendicectomy, antibiotic therapy, or both?Annals of medicine and surgery (2012) · 2023Article
- Complicated appendicitis, acute pancreatitis, pleural effusion, and sinus bradycardia in a COVID-19 patient.Clinical case reports · 2023Article
- Increase in pediatric complicated appendicitis during the COVID-19 pandemic: a multi-center retrospective study.Surgery today · 2022Article
- Paediatric appendicitis: international study of management in the COVID-19 pandemic.The British journal of surgery · 2022Article
- Impact of the first COVID-19 surge on the outcomes of diverticulitis.Surgery in practice and science · 2022Article
- Impact of COVID-19 on the incidence of CT-diagnosed appendicitis and its complications in the UK and Sweden.International journal of colorectal disease · 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
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12 authors at 5 institutions in 1 country.
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Abstract
backgroundThe coronavirus disease 2019 pandemic restricted movement of individuals and altered provision of health care, abruptly transforming health care-use behaviors. It serves as a natural experiment to explore changes in presentations for surgical diseases including acute appendicitis. The objective was to determine if the pandemic was associated with changes in incidence of acute appendicitis compared to a historical control and to determine if there were associated changes in disease severity.
methodsThe study is a retrospective, multicenter cohort study of adults (N = 956) presenting with appendicitis in nonpandemic versus pandemic time periods (December 1, 2019-March 10, 2020 versus March 11, 2020-May 16, 2020). Corresponding time periods in 2018 and 2019 composed the historical control. Primary outcome was mean biweekly counts of all appendicitis presentations, then stratified by complicated (n = 209) and uncomplicated (n = 747) disease. Trends in presentations were compared using difference-in-differences methodology. Changes in odds of presenting with complicated disease were assessed via clustered multivariable logistic regression.
resultsThere was a 29% decrease in mean biweekly appendicitis presentations from 5.4 to 3.8 (rate ratio = 0.71 [0.51, 0.98]) after the pandemic declaration, with a significant difference in differences compared with historical control (P = .003). Stratified by severity, the decrease was significant for uncomplicated appendicitis (rate ratio = 0.65 [95% confidence interval 0.47-0.91]) when compared with historical control (P = .03) but not for complicated appendicitis (rate ratio = 0.89 [95% confidence interval 0.52-1.52]); (P = .49). The odds of presenting with complicated disease did not change (adjusted odds ratio 1.36 [95% confidence interval 0.83-2.25]).
conclusionThe pandemic was associated with decreased incidence of uncomplicated appendicitis without an accompanying increase in complicated disease. Changes in individual health care-use behaviors may underlie these differences, suggesting that some cases of uncomplicated appendicitis may resolve without progression to complicated disease.
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