Cruz Cruz Dyan, Ramos Mantilla Andrea, Valenzuela Aguilera Marco, Rodríguez Villablanca Javiera
Cirugía Pediátrica, Hospital Roberto del Río, Santiago, Chile.
Andes Pediatr. 2024 Oct;95(5):564-572. doi: 10.32641/andespediatr.v95i5.4954.
Acute appendicitis (AA) is the most frequent cause of acute surgical abdomen in pediatrics. During the COVID-19 pandemic, lockdown slowed surgical processes, delaying medical consultations.
To analyze the impact of the pandemic on the presentation and management of acute appendicitis.
Retrospective cohort, which included patients under 15 years of age seen in the emergency department (ED) with a diagnosis of acute appendicitis, from March to December of the pre-pandemic period of 2018 and the pandemic period in 2020. Demographic data, symptoms, treatment, and complications were analyzed. Patients were divided into groups based on the severity of the condition. A statistically significant difference of p < 0.05 was demonstrated.
629 patients with AA from both periods were included. The evolution time from the onset of symptoms to the consultation of all patients with AA in the pandemic was longer, with 41.2 hours versus 35.5 hours in the pre-pandemic period (p < 0.05), and in the subgroup of complicated acute appendicitis (CAA), it was 59.5 hours versus 45.4 hours in the pandemic and pre-pandemic periods (p < 0.01), respectively. Admission to the intensive care unit was higher in the pandemic, with 3.9% versus 0.6% in the pre-pandemic period (p < 0.05). In the case of appendicular phlegmon, it had greater hospital stay in the pandemic with 11.6 days versus 7.8 days in the pre-pandemic period (p < 0.05) and longer antibiotic treatment with 17 days in the pandemic versus 11.1 days in the prepandemic period (p < 0.05). The surgical approach in the pandemic was mainly laparoscopic with 62.4% (p < 0.001).
During the pandemic, there was a delay in consultation and a greater requirement for intensive management in patients with acute appendicitis. The hospital stays and antibiotic treatment of appendiceal phlegmon were longer and the laparoscopic technique was the surgical approach of choice.
急性阑尾炎（AA）是小儿急性外科急腹症最常见的病因。在新冠疫情期间，封锁减缓了手术进程，延误了医疗咨询。
分析疫情对急性阑尾炎的表现及治疗的影响。
回顾性队列研究，纳入2018年疫情前时期3月至12月以及2020年疫情期间在急诊科就诊的15岁以下诊断为急性阑尾炎的患者。分析人口统计学数据、症状、治疗及并发症情况。根据病情严重程度将患者分组。显示出p < 0.05的统计学显著差异。
纳入两个时期的629例急性阑尾炎患者。疫情期间所有急性阑尾炎患者从症状出现到就诊的演变时间更长，分别为41.2小时和疫情前时期的35.5小时（p < 0.05），在复杂急性阑尾炎（CAA）亚组中，疫情期间和疫情前时期分别为59.5小时和45.4小时（p < 0.01）。疫情期间重症监护病房的收治率更高，分别为3.9%和疫情前时期的0.6%（p < 0.05）。在阑尾脓肿的情况下，疫情期间住院时间更长，分别为11.6天和疫情前时期的7.8天（p < 0.05），抗生素治疗时间更长，疫情期间为17天，疫情前时期为11.1天（p < 0.05）。疫情期间的手术方式主要为腹腔镜手术，占62.4%（p < 0.001）。
疫情期间，急性阑尾炎患者的咨询延迟，强化治疗需求更大。阑尾脓肿的住院时间和抗生素治疗时间更长，腹腔镜技术是首选的手术方式。
