Dataset Information

Management of pediatric appendicitis during the COVID-19 pandemic: A nationwide multicenter cohort study.

ABSTRACT:

Background

The COVID-19 pandemic has impacted timely access to care for children, including patients with appendicitis. This study aimed to evaluate the effect of the COVID-19 pandemic on management of appendicitis and patient outcomes.

Methods

A multicenter retrospective study was performed including 19 children's hospitals from April 2019-October 2020 of children (age≤18 years) diagnosed with appendicitis. Groups were defined by each hospital's city/state stay-at-home orders (SAHO), designating patients as Pre-COVID (Pre-SAHO) or COVID (Post-SAHO). Demographic, treatment, and outcome data were obtained, and univariate and multivariable analysis was performed.

Results

Of 6,014 patients, 2,413 (40.1%) presented during the COVID-19 pandemic. More patients were managed non-operatively during the COVID-19 pandemic compared to before the pandemic (147 (6.1%) vs 144 (4.0%), p < 0.001). Despite this change, there was no difference in the proportion of complicated appendicitis between groups (1,247 (34.6%) vs 849 (35.2%), p = 0.12). COVID era non-operative patients received fewer additional procedures, including interventional radiology (IR) drain placements, compared to pre-COVID non-operative patients (29 (19.7%) vs 69 (47.9%), p < 0.001). On adjusted analysis, factors associated with increased odds of receiving non-operative management included: increasing duration of symptoms (OR=1.01, 95% CI: 1.01-1.012), African American race (OR=2.4, 95% CI: 1.3-4.6), and testing positive for COVID-19 (OR=10.8, 95% CI: 5.4-21.6).

Conclusion

Non-operative management of appendicitis increased during the COVID-19 pandemic. Additionally, fewer COVID era cases required IR procedures. These changes in the management of pediatric appendicitis during the COVID pandemic demonstrates the potential for future utilization of non-operative management.

SUBMITTER: Hegde B

PROVIDER: S-EPMC9374489 | biostudies-literature | 2022 Aug

REPOSITORIES: biostudies-literature

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Publications

Management of pediatric appendicitis during the COVID-19 pandemic: A nationwide multicenter cohort study.

Hegde Brittany B Garcia Elisa E Hu Andrew A Raval Mehul M Takirambudde Sanyu S Wakeman Derek D Lewit Ruth R Gosain Ankush A Parrado Raphael H RH Cina Robert A RA Stephenson Krista K Dassinger Melvin S MS Zhang Daniel D Mustafa Moiz M MM Koo Donna D Lipskar Aaron M AM Scheidler Katherine K Van Arendonk Kyle J KJ Berg Patrick P Gonzalez Raquel R Scheese Daniel D Haynes Jeffrey J Mina Alexander A Zamora Irving J IJ Lopez Monica E ME Mehl Steven C SC Gilliam Elizabeth E Lofberg Katrina K Spencer Brianna B Kulaylat Afif N AN Gulack Brian C BC Johnson Matthew M Laskovy Matthew M Brahmamdam Pavan P Shimomura Aoi A Blanch Therese T Tsao KuoJen K Slater Bethany J BJ

Journal of pediatric surgery 20220813 7

<h4>Background</h4>The COVID-19 pandemic has impacted timely access to care for children, including patients with appendicitis. This study aimed to evaluate the effect of the COVID-19 pandemic on management of appendicitis and patient outcomes.<h4>Methods</h4>A multicenter retrospective study was performed including 19 children's hospitals from April 2019-October 2020 of children (age≤18 years) diagnosed with appendicitis. Groups were defined by each hospital's city/state stay-at-home orders (SA ...[more]

PMID: 36075771

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Project description:BackgroundElevated rates of suicidal behavior were reported during the COVID-19 pandemic. However, information is scarce on patients' profiles during this period. Studies evoke the potential adverse effects of the mandatory lockdown, but they remain relatively speculative.MethodsWe monitored fluctuations in suicide attempts (SA) in six European countries. We gathered data, retrospectively for under 18-year-old SA episodes (1 January 2018 to 31 December 2021), through records of psychiatric emergency services. We collected clinical profiles individually. We extracted environmental indicators by month, as provided by Oxford COVID-19 Government Response Tracker (OxCGRT). We used the Pruned Exact Linear Time (PELT) method to identify breakpoints in SA episodes reported for each country, and logistic regressions to estimate changes in patients' characteristics after the breakpoints. Finally, we used a univariate and multivariate negative binomial model to assess the link between SA and OxCGRT indicators, accounting for the delay (lag) between the interventions and their impact on SA.ResultsThe study comprised 2,833 children and adolescents (mean age = 15.1 years (SD 1.6); M: F sex-ratio = 1:5.4). A significant increase in SA was found either 6 or 10 months after the beginning of the pandemic, varying by country. Patients were more likely to be girls (aOR = 1.77 [1.34; 2.34]) and used SA methods "other than self-poisoning" (aOR = 1.34 [1.05; 1.7]). In the multivariate model, an association was found between SA and the contact tracing indicator with an 11 months delay, and the number of COVID-19 deaths with a 3-months delay.ConclusionsFindings confirmed a delayed increase in SA during the COVID-19 pandemic in children and adolescents as well as changes in patients' profiles. The duration and severity of the pandemic emerged as the strongest predictor in the rise of SA. If faced with a similar pandemic in the future, the gap between the onset of pandemic and the increase in suicide attempts presents an opportunity for prevention.

Dataset Information

Management of pediatric appendicitis during the COVID-19 pandemic: A nationwide multicenter cohort study.

Background

Methods

Results

Conclusion

Publications

Management of pediatric appendicitis during the COVID-19 pandemic: A nationwide multicenter cohort study.

Similar Datasets

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