Impact of the COVID-19 pandemic on the clinical management trends for acute appendicitis among the under-25s: a retrospective study.

Faitna, Puji, Harwood, Rachel ORCID: 0000-0003-3440-3142, Kenny, Simon E, Viner, Russell M, Aylin, Paul P, Hargreaves, Dougal S and Bottle, Alex (2024) 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, 109 (4). pp. 339-346.

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Official URL: http://dx.doi.org/10.1136/archdischild-2023-326313

Abstract

<h4>Objective</h4>To describe the COVID-19 pandemic's impact on acute appendicitis management on children and young people (CYP).<h4>Design</h4>Retrospective cohort study.<h4>Setting</h4>All English National Health Service hospitals.<h4>Patients</h4>Acute appendicitis admissions (all, simple, complex) by CYP (under-5s, 5-9s, 10-24s).<h4>Exposure</h4>Study pandemic period: February 2020-March 2021. Comparator pre-pandemic period: February 2015-January 2020.<h4>Main outcome measures</h4>Monthly appendicectomy and laparoscopic appendicectomy rate trends and absolute differences between pandemic month and the pre-pandemic average. Proportions of appendicitis admissions comprising complex appendicitis by hospital with or without specialist paediatric centres were compared.<h4>Results</h4>101 462 acute appendicitis admissions were analysed. Appendicectomy rates fell most in April 2020 for the 5-9s (-18.4% (95% CI -26.8% to -10.0%)) and 10-24s (-28.4% (-38.9% to -18.0%)), driven by reductions in appendicectomies for simple appendicitis. This was equivalent to -54 procedures (-68.4 to -39.6) and -512 (-555.9 to -467.3) for the 5-9s and 10-24s, respectively. Laparoscopic appendicectomies fell in April 2020 for the 5-9s (-15.5% (-23.2% to -7.8%)) and 10-24s (-44.8% (-57.9% to -31.6%) across all types, which was equivalent to -43 (-56.1 to 30.3) and -643 (-692.5 to -593.1) procedures for the 5-9s and 10-24s, respectively. A larger proportion of complex appendicitis admissions were treated within trusts with specialist paediatric centres during the pandemic.<h4>Conclusions</h4>For CYP across English hospitals, a sharp recovery followed a steep reduction in appendicectomy rates in April 2020, due to concerns with COVID-19 transmission. This builds on smaller-sized studies reporting the immediate short-term impacts.

Item Type:	Article
Uncontrolled Keywords:	Humans, Appendicitis, Acute Disease, Retrospective Studies, Adolescent, Child, State Medicine, Pandemics, COVID-19
Divisions:	Faculty of Health and Life Sciences Faculty of Health and Life Sciences > Institute of Life Courses and Medical Sciences
Depositing User:	Symplectic Admin
Date Deposited:	09 Apr 2024 09:14
Last Modified:	09 Apr 2024 13:31
DOI:	10.1136/archdischild-2023-326313
Open Access URL:	https://adc.bmj.com/content/109/4/339
Related URLs:	Author Publisher
URI:	https://livrepository.liverpool.ac.uk/id/eprint/3180174