WTP4.8 Management of Acute appendicitis during the COVID-19 pandemic A single centre retrospective cohort study

Abstract

Abstract Background Management of Acute appendicitis changed significantly in the UK during COVID-19. The aim of study was to compare management of Acute appendicitis before and during COVID-19 pandemic. Materials and Methods We performed a single centre retrospective cohort study in UK comparing the management of acute appendicitis before the pandemic from March - August 2019 and during the Pandemic from March- August 2020. Results Over period of 6 months, a total of 179 patients were diagnosed with Acute appendicitis in 2019 versus 152 in 2020. In 2019, median age was 33 and 52% (n=93) patients were female. In 2020, median age was 37 and 48% (n=73) of the patients were female. At first presentation, in 2019, 97% of the patients (174/179) received surgical treatment compared to 70% (107/152) in 2020. 3% of the patients (n=5) were managed conservatively in 2019 as compared to 30% (n=45) in 202. Pre-Pandemic only 32% of the patients received imaging to confirm the diagnosis as compared to 53% during pandemic. During 2019, 92% (n=161) of the patients who received surgical treatment underwent laparoscopic surgery as compared to only 74% (n=95) in 2020. Post op complications occurred in 5% (n=9/176) of the surgical patients in 2019 as compared to 13% (n=16/128) in 2020. Mean length of hospital stay in 2019 was 3 (1-11) days versus 5 (1-35) in 2020. 30-day readmission rate was 5% (8/179) versus 19% (29/152). Conclusion Our study shows that the change in management of acute appendicitis during Pandemic was associated with longer length of hospital stay, more readmissions and increase in post-operative complications.