Motazedian Gholamreza, Aryanpoor Poorya, Rahmanian Ehsan, Abiri Samaneh, Kalani Navid, Hatami Naser, Bagherian Farhad, Etezadpour Mohammad, Farzaneh Roohie, Maleki Fatemeh, Foroughian Mahdi, Ghaedi Mojtaba
Plastic & Reconstructive Surgery Department, Shiraz University of Medical Sciences, Shiraz, Iran.
Student Research Committee, Jahrom University of Medical Sciences, Jahrom, Iran.
Arch Acad Emerg Med. 2021 Jan 1;10(1):e3. doi: 10.22037/aaem.v10i1.1421. eCollection 2022.
COVID-19 has affected the pattern of referral to medical centers and quarantine against COVID-19 might delay referral and management of surgical emergencies. This study aimed to compare the pooled event rate of pediatric perforated appendicitis before and during the COVID-19 pandemic.
This was a systematic review and meta-analysis study based on the PRISMA guidelines. Scopus, Web of Sciences, and PubMed databases were searched for studies reporting the rate of perforated appendicitis based on the post-appendectomy observations or imaging methods. The Egger bias test and funnel plot were used to detect and depict publication bias. Statistical analysis was performed in Comprehensive Meta-analysis package version 3.
Twelve studies were eligible for inclusion in our study. The pooled prevalence of pediatric perforated appendicitis in the pre-COVID era was 28.5% (CI95%: 28.3 to 28.7%) with a heterogeneity of 99%. In the COVID era, the event rate proportion was 39.4% (CI95%: 36.6 to 42.3%) with a heterogeneity of 99%. There was a significant difference in the subgroup analysis within the pre-COVID and COVID era (P<0.001), showing a higher perforation rate in the COVID era.
Our study showed that during the COVID-19 pandemic, the rate of perforated appendicitis has significantly increased in comparison to before the COVID-19 pandemic.
新型冠状病毒肺炎（COVID-19）已经影响了向医疗中心转诊的模式，针对COVID-19的隔离措施可能会延迟外科急症的转诊和处理。本研究旨在比较COVID-19大流行之前和期间小儿穿孔性阑尾炎的合并事件发生率。
这是一项基于PRISMA指南的系统评价和荟萃分析研究。在Scopus、科学网和PubMed数据库中检索基于阑尾切除术后观察结果或成像方法报告穿孔性阑尾炎发生率的研究。使用Egger偏倚检验和漏斗图来检测和描述发表偏倚。在综合荟萃分析软件包版本3中进行统计分析。
12项研究符合纳入我们研究的条件。COVID-19大流行前小儿穿孔性阑尾炎的合并患病率为28.5%（95%CI：28.3%至28.7%），异质性为99%。在COVID-19大流行期间，事件发生率比例为39.4%（95%CI：36.6%至42.3%），异质性为99%。在COVID-19大流行前和期间的亚组分析中存在显著差异（P<0.001），表明COVID-19大流行期间穿孔率更高。
我们的研究表明，在COVID-19大流行期间，与COVID-19大流行之前相比，穿孔性阑尾炎的发生率显著增加。
