Impact of the COVID-19 pandemic on appendicitis treatment in Germany-a population-based analysis.
Impact of the COVID-19 pandemic on appendicitis treatment in Germany-a population-based analysis.
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COVID-19 大流行对德国阑尾炎治疗的影响——基于人群的分析。
DOI：
10.1007/s00423-021-02081-4
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发表时间：
2021-03
期刊：
影响因子：
--
通讯作者：
Wiegering A
中科院分区：
文献类型：
--
作者：
Köhler F;Acar L;van den Berg A;Flemming S;Kastner C;Müller S;Diers J;Germer CT;Lock JF;L'hoest H;Marschall U;Wiegering A
急性阑尾炎是急诊就诊最常见的原因之一。单纯性阑尾炎可以用抗生素或手术治疗，而包括坏疽、脓肿和穿孔在内的复杂阑尾炎则需要阑尾切除术。在2020年初2019冠状病毒病大流行期间，观察到急诊室就诊人数总体下降。因此，我们的目的是调查急性阑尾炎在这一时期的发病率和治疗策略。回顾性分析德国某大型健康保险公司ICD编码为“急性阑尾炎”或OPS手术的投保人资料。建立分组，包含2017年3月至6月、2018年和2019年的平均值，定义为“pre-COVID组”，“COVID组”定义为2020年3月至6月的数据。数据按年龄、性别、合并症、住院时间、诊断和治疗进行分析。分析COVID组同时感染COVID-19的数据。在2020年初的COVID-19大流行期间，急性阑尾炎患者总体减少了12.9%。这些结果主要是由于单纯性阑尾炎发病率下降，而复合性阑尾炎几乎没有受到影响。特别是在40岁以下的女性群体中，这种急剧下降是显而易见的。延长手术的比率没有改变。术后并发症如阑尾残端渗漏或需要再次手术的发生率也无差异。2020年3月，4.8%的急性阑尾炎患者合并了COVID-19感染。与2020年春季德国COVID-19大流行期间急诊室就诊人数总体下降一致，非复杂性阑尾炎患者人数显著减少，而复杂性阑尾炎患者人数没有差异。急性阑尾炎的治疗和并发症发生率没有变化。这些发现可能提示急性阑尾炎不是一种进展性疾病，而非复杂性阑尾炎和复杂性阑尾炎是由不同的实体引起的，从而提示非复杂性阑尾炎可以使用抗生素或观察治疗。然而，所提供的数据不包括门诊治疗；因此，不能对门诊患者进行观察或抗生素治疗。
Acute appendicitis is one of the most common reasons for emergency medical consultation. While simple appendicitis can be treated with antibiotics or surgery, complex appendicitis including gangrene, abscess, and perforation requires appendectomy. During the COVID-19 pandemic in early 2020, an overall drop in emergency room consultations was observed. We therefore aimed to investigate the incidence and treatment strategies of acute appendicitis during that period. Data of insurance holders with the ICD code for “acute appendicitis” or OPS procedure of appendectomy of a major health insurance company in Germany were analyzed retrospectively. Groups were built, containing of the means of March–June of 2017, 2018, and 2019, defined as “pre-COVID group” with the “COVID group,” defined as data from March to June of 2020. Data was analyzed by age, sex, comorbidities, length of hospital stay, diagnoses, and treatment. Data of the COVID group was analyzed for simultaneous COVID-19 infection. During the COVID-19 pandemic of early 2020, an overall reduction by 12.9% of patients presenting with acute appendicitis was noticeable. These results were mainly due to decreased rates of uncomplicated appendicitis, while complicated appendicitis was scarcely affected. Especially in the group of females < 40 years, a drastic reduction was visible. Rates of extended surgery did not change. Likewise, the complication rate like appendix stump leakage or need for re-operation did not differ. In March 2020, 4.8% of acute appendicitis patients had concomitant COVID-19 infection. In line with the overall drop of emergency room visits during the COVID-19 pandemic of spring 2020 in Germany, a significantly lowered number of patients with uncomplicated appendicitis were noticeable, whereas complicated appendicitis did not differ. Also, treatment and complication rate of acute appendicitis did not change. These findings might be a hint that acute appendicitis is not a progressing disease but caused by different entities for uncomplicated and complicated appendicitis and therefore another clue that uncomplicated appendicitis can be treated with antibiotics or observation. Nevertheless provided data does not cover outpatient treatment; therefore, no statement observation or antibiotics in outpatients can be made.
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影响因子：
2.3
作者：
Flemming, S.;Hankir, M.;Wiegering, A.
通讯作者：
Wiegering, A.
影响因子：
1.5
作者：
Abdalhadi, Ahmed;Alkhatib, Mohammed;Albarqouni, Loai
通讯作者：
Albarqouni, Loai
影响因子：
3.4
作者：
Kangaspunta, Helmi;Tahkola, Kyosti;Ukkonen, Mika
通讯作者：
Ukkonen, Mika
DOI：
10.1097/ta.0000000000001378
发表时间：
2017-04-01
期刊：
The journal of trauma and acute care surgery
影响因子：
--
作者：
Loftus, Tyler J;Raymond, Steven L;Jordan, Janeen R
通讯作者：
Jordan, Janeen R
DOI：
10.1007/s10272-020-0886-0
发表时间：
2020-01-01
期刊：
Inter economics
影响因子：
--
作者：
Prante, Franz J;Bramucci, Alessandro;Truger, Achim
通讯作者：
Truger, Achim