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).
Appendectomy
Appendicitis
COVID-19 Pandemic
Machine learning
Journal
Updates in surgery
ISSN: 2038-3312
Titre abrégé: Updates Surg
Pays: Italy
ID NLM: 101539818
Informations de publication
Date de publication:
Dec 2021
Dec 2021
Historique:
received:
11
05
2021
accepted:
25
06
2021
pubmed:
6
7
2021
medline:
24
11
2021
entrez:
5
7
2021
Statut:
ppublish
Résumé
Major surgical societies advised using non-operative management of appendicitis and suggested against laparoscopy during the COVID-19 pandemic. The hypothesis is that a significant reduction in the number of emergent appendectomies was observed during the pandemic, restricted to complex cases. The study aimed to analyse emergent surgical appendectomies during pandemic on a national basis and compare it to the same period of the previous year. This is a multicentre, retrospective, observational study investigating the outcomes of patients undergoing emergent appendectomy in March-April 2019 vs March-April 2020. The primary outcome was the number of appendectomies performed, classified according to the American Association for the Surgery of Trauma (AAST) score. Secondary outcomes were the type of surgical technique employed (laparoscopic vs open) and the complication rates. One thousand five hundred forty one patients with acute appendicitis underwent surgery during the two study periods. 1337 (86.8%) patients met the inclusion criteria: 546 (40.8%) patients underwent surgery for acute appendicitis in 2020 and 791 (59.2%) in 2019. According to AAST, patients with complicated appendicitis operated in 2019 were 30.3% vs 39.9% in 2020 (p = 0.001). We observed an increase in the number of post-operative complications in 2020 (15.9%) compared to 2019 (9.6%) (p < 0.001). The following determinants increased the likelihood of complication occurrence: undergoing surgery during 2020 (+ 67%), the increase of a unit in the AAST score (+ 26%), surgery performed > 24 h after admission (+ 58%), open surgery (+ 112%) and conversion to open surgery (+ 166%). In Italian hospitals, in March and April 2020, the number of appendectomies has drastically dropped. During the first pandemic wave, patients undergoing surgery were more frequently affected by more severe appendicitis than the previous year's timeframe and experienced a higher number of complications. Trial registration number and date: Research Registry ID 5789, May 7th, 2020.
Identifiants
pubmed: 34219197
doi: 10.1007/s13304-021-01126-z
pii: 10.1007/s13304-021-01126-z
pmc: PMC8255092
doi:
Types de publication
Journal Article
Multicenter Study
Observational Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
2205-2213Investigateurs
M Guerrieri
(M)
M Ortenzi
(M)
F Cavallo
(F)
M Zese
(M)
D Prando
(D)
E Restini
(E)
P Cianci
(P)
P Millo
(P)
R Brachet Contul
(R)
A Serrao
(A)
F Abatini
(F)
D F Altomare
(DF)
A Picciariello
(A)
G Chetta
(G)
F Lattanzio
(F)
V Tonini
(V)
A Gori
(A)
E Jovine
(E)
L Mastrangelo
(L)
L Sartarelli
(L)
A Frena
(A)
A Malpaga
(A)
F Bertelli
(F)
G Pignata
(G)
J Andreuccetti
(J)
S Sanna
(S)
B Lares
(B)
R Sechi
(R)
N Cillara
(N)
A Pisanu
(A)
D Delogu
(D)
G Ciaccio
(G)
M Farulla
(M)
M Casati
(M)
L Laface
(L)
M De Luca
(M)
D Russello
(D)
S Latteri
(S)
M Longoni
(M)
E Masci
(E)
S Vigna
(S)
F C Campanile
(FC)
N Foti
(N)
P Lepiane
(P)
A Balla
(A)
F Cantore
(F)
V Raveglia
(V)
F Borghi
(F)
G Giraudo
(G)
A Verzelli
(A)
A Budassi
(A)
A Patriti
(A)
D Foghetti
(D)
U Montin
(U)
L Amadio
(L)
G Anania
(G)
C Bombardini
(C)
Niccolò Fabbri
(N)
Carlo Feo
(C)
F Cianchi
(F)
A Manetti
(A)
M Lucchese
(M)
E Soricelli
(E)
G Ceccarelli
(G)
M Patiti
(M)
M Frascio
(M)
C Stabilini
(C)
M Filauro
(M)
A Barberis
(A)
M Troian
(M)
C Nagliati
(C)
R Campagnacci
(R)
A Maurizi
(A)
S Berti
(S)
A Gennai
(A)
A Marvaso
(A)
D D'Antonio
(D)
C V Feo
(CV)
N Fabbri
(N)
L Mazzola
(L)
F Selvaggi
(F)
S Carini
(S)
F Costanzo
(F)
L Boccia
(L)
A Pascariello
(A)
N Perrotta
(N)
M Celiento
(M)
E Opocher
(E)
M Giovenzana
(M)
M Stella
(M)
F Ferrara
(F)
L Boni
(L)
E Abate
(E)
C Da Lio
(C)
V Valli
(V)
R Gelmini
(R)
F Serra
(F)
M Piccoli
(M)
D Gozzo
(D)
A Gattolin
(A)
D Sasia
(D)
A Balani
(A)
B Petronio
(B)
P G Calò
(PG)
G L Canu
(GL)
E Contarini
(E)
G Piatto
(G)
N Vettoretto
(N)
M Caprioli
(M)
M Braga
(M)
M F Chiappetta
(MF)
P Maida
(P)
P Tammaro
(P)
G De Palma
(G)
M Milone
(M)
V Bottino
(V)
A Canfora
(A)
F Selvaggi
(F)
G Bagaglini
(G)
A Agrusa
(A)
M Barone
(M)
A Mirabella
(A)
M V Marino
(MV)
G Gulotta
(G)
G Romano
(G)
M Sorrentino
(M)
S Ferfoglia
(S)
V Papagni
(V)
S Eramo
(S)
C Boselli
(C)
M Basti
(M)
V Caracino
(V)
G Moretto
(G)
M Inama
(M)
P Capelli
(P)
L Conti
(L)
A Muratore
(A)
M M Cuoghi
(MM)
A Zerbinati
(A)
S Corso
(S)
M C Vasino
(MC)
M Montuori
(M)
F Fidanza
(F)
A Lucchetta
(A)
A Giuliani
(A)
G Dinatale
(G)
F Zanzi
(F)
A Guariniello
(A)
S Bonilauri
(S)
G Frazzetta
(G)
M Garino
(M)
C Marafante
(C)
A Gioffrè
(A)
S R Del Monte
(SR)
G Sganga
(G)
P Fransvea
(P)
M Grande
(M)
L Siragusa
(L)
G Sica
(G)
M Paola
(M)
D G Passantino
(DG)
Marco Catani
(M)
F Ricci
(F)
E Lauro
(E)
E Facci
(E)
D Parini
(D)
M F Armellino
(MF)
G Argenio
(G)
A Porcu
(A)
T Perra
(T)
P Bordoni
(P)
F Fleres
(F)
A Parisi
(A)
S Rossi
(S)
R Saracco
(R)
D Bono
(D)
T Viora
(T)
F Orlando
(F)
A Ferrero
(A)
A P Fontana
(AP)
P De Paolis
(P)
D Visconti
(D)
F Quaglino
(F)
F Festa
(F)
S Palagi
(S)
G Lo Secco
(G)
M Morino
(M)
M E Allaix
(ME)
A Salzano
(A)
G Tirone
(G)
M Motter
(M)
G Zanus
(G)
N Passuello
(N)
M Massani
(M)
R Tutino
(R)
N Manzini
(N)
S Terranova
(S)
R Merenda
(R)
S Nordio
(S)
S Zonta
(S)
F Lovisetto
(F)
A Guglielmi
(A)
T Campagnaro
(T)
E Amedeo
(E)
M Scollica
(M)
P Amodio
(P)
D Giannotti
(D)
S Olmi
(S)
A Oldani
(A)
Informations de copyright
© 2021. The Author(s).
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