Acute appendicitis at Oslo University Hospital before and after Covid-19 restrictions: Business as usual or delay?

Abstract
The Norwegian health directory decided “lockdown” Thursday the 12.th of March to reduce the spread of Covid-19.
The surgical department at Oslo university Hospital Ulleval (OUH-U), like other specialties, experienced a decrease in emergency admissions. In OUH-U, a major Scandinavian emergency hospital, acute appendectomy is the most frequent surgical procedure. The aim with this study was therefor to explore whether the reduction in emergency admissions resulted in an increase in complicated appendicitis.
 
Material and method:
The study is designed as a combined retro- and prospective cohort study, including patients undergoing appendectomy in a four-week period before and after the 12.th of March. Anonymized patient information was collected from electronic patient chart and analyzed in SPSS after approval from local Institutional Data Protection Officer.
 
Results:
96 appendectomies were included, 58 in the first (preCovid) period and 38 int the last (postCovid) period. The groups were comparable regarding clinical and demographic data and the number of appendectomies were similar to the same periods in 2019. The time from arrival at the emergency department (ED) to surgery was significantly increased in the postCovid period, but there were no differences in rate of complicated appendicitis, rate of complications or length of stay (LOS) between the periods.
 
Discussion:
The management of appendicitis has not changed in our institution during the pandemic. The increased time from arrival ED to surgery might be caused by the time-consuming Covid-test. However, the rate of complicated appendicitis remained unchanged.
The weakness of this study is short study period and limited patient number.
 
Project leader:
 
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