Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Oct;47(5):1359-1365.
doi: 10.1007/s00068-021-01663-7. Epub 2021 Apr 12.

The decrease of non-complicated acute appendicitis and the negative appendectomy rate during pandemic

Marco Ceresoli  1 , Federico Coccolini  2 , Stefano Magnone  3 , Alessandro Lucianetti  3 , Pietro Bisagni  4 , Teodora Armao  4 , Luca Ansaloni  5 , Mauro Zago  6 , Massimo Chiarugi  2 , Fausto Catena  7 , Marco Braga  8 ; Appendicitis-COVID study group
Collaborators, Affiliations

The decrease of non-complicated acute appendicitis and the negative appendectomy rate during pandemic

Marco Ceresoli et al. Eur J Trauma Emerg Surg. 2021 Oct.

Erratum in

Abstract

Background: During pandemic, admissions for surgical emergencies dropped down dramatically. Also acute appendicitis decreased. The aim of the present study was to evaluate the change in volume and clinical presentation of patients with acute appendicitis during pandemic and the variation in treatment.

Methods: This is a retrospective study of patients admitted in 11 Italian hospital for acute appendicitis during the lockdown period (March-April 2020) compared with the same period of the previous 2 years (2018-2019). The number and the rate of complicated and non-complicated acute appendicitis were recorded and compared between the two study periods; non-operative vs operative treatment and negative appendectomy rate were also recorded.

Results: The study included 532 patients, 112 in the study period and 420 in the control period; Hospital admission for acute appendicitis dropped by 46% (OR 0.516 95% CI 0.411-0.648 p < 0.001) during the 2020 lockdown. The number of complicated acute appendicitis did not change (- 18%, OR 0.763 95% CI 0.517-1.124 p = 0.1719), whereas the number of non-complicated acute appendicitis significantly decreased (- 56%, OR 0.424 95% CI 0.319-0.564 p < 0.001). Non-operative treatment rate remained similar (12.1% vs. 11.6% p = 0.434). The negative appendectomy rate also significantly decreased (6.1% vs. 17.3%, p = 0.006).

Conclusions: The present study found a significant reduction of both admissions for non-complicated acute appendicitis and negative appendectomy rate during the pandemic period. Conversely, admissions for complicated acute appendicitis did not change.

Trial registration: NCT04649996.

Keywords: Acute appendicitis; COVID-19; Non-complicated acute appendicitis.

PubMed Disclaimer

Conflict of interest statement

All the authors have no conflict of interest to declare.

Figures

Fig. 1
Fig. 1
Included study centers with local prevalence of SARS-CoV2 infections
Fig. 2
Fig. 2
Number of non-complicated and complicated acute appendicitis during the study periods
Fig. 3
Fig. 3
Linear correlation between prevalence of SARS-CoV2 infection and % change in hospital admission due to acute appendicitis
See this image and copyright information in PMC

References

    1. Livingston E, Vons C. Treating appendicitis without surgery. JAMA - J Am Med Assoc. 2015;313(23):2327–2328. doi: 10.1001/jama.2015.6266. - DOI - PubMed
    1. Ferris S, Quan S, Kaplan BS, Molodecky N, Ball CG, Chernoff GW, et al. The global incidence of appendicitis: a systematic review of population-based studies. Ann Surg. 2017;266:237–41. doi: 10.1097/SLA.0000000000002188. - DOI - PubMed
    1. Ceresoli M, Zucchi A, Allievi N, Harbi A, Pisano M, Montori G, et al. Acute appendicitis: Epidemiology, treatment and outcomes- analysis of 16544 consecutive cases. World J Gastrointest Surg [Internet]. 2016;8:693. Available from: http://www.wjgnet.com/1948-9366/full/v8/i10/693.htm - PMC - PubMed
    1. Andersson RE. The natural history and traditional management of appendicitis revisited: spontaneous resolution and predominance of prehospital perforations imply that a correct diagnosis is more important than an early diagnosis. World J Surg. 2007;31:86–92. doi: 10.1007/s00268-006-0056-y. - DOI - PubMed
    1. Blomqvist PG, Andersson RE, Granath F, Lambe MP, Ekbom AR. Mortality after appendectomy in Sweden, 1987–1996. Ann Surg. 2001;233:455–60. doi: 10.1097/00000658-200104000-00001. - DOI - PMC - PubMed

Associated data

LinkOut - more resources