978 Acute Appendicitis in The Age of COVID-19 – How Changing Standards Affect Patient Outcomes

Abstract

IntroductionThe COVID-19 -19 pandemic has forced changes in the management of Acute Appendicitis (AA), such as prioritising conservative management and avoiding laparoscopic procedures. We aim to assess how these changes affected patient outcomes in comparison to routine practice during the same time frame in 2019.The primary study outcomes are operative intervention, length of stay and hospital re-admission within 30 days.MethodRetrospective data collection for all patients admitted to Ipswich Hospital with suspicion of AA since lockdown came into effect in England on March 23 up to May 10th, 2020 and the same time frame in 2019.Results23 patients were admitted during the lockdown period. 39%(N = 9) were treated conservatively.14 (61%) operatively, of which 71% (N = 10) had open appendicectomy while 29% (N = 4) underwent laparoscopic appendicectomies. The mean Length of Stay(LOS) was 3.83 days. In 2019,21 patients were admitted. 33%(N = 7) were treated conservatively. All appendicectomies were laparoscopic. Mean LOS was 2 days.Re-admission rates were similar in both groups.ConclusionsDue to Covid19 a majority of patients requiring surgery underwent open appendicectomies. We noted a significant increase in both length of stay and progression from non-operative to operative intervention rates compared to 2019. The general case load was similar.