ARCIMS 26
in
Sunday 2025-10-19 19:10
Comparison of Acute Appendicitis Complications Before and During the COVID-19 Pandemic: A Retrospective Cohort Study (2017–2021)
Reyhaneh Khalifeh Arani 1 ℗, Hossein Sadeghi Hassan Abadi 2 ©, Sajjad Sadeghpour 1, Seyed Alireza Moravveji 3, Seyed Amir Hassan Matini 4
Abstract
Introduction: Acute appendicitis is the most common surgical emergency of the abdomen. During the COVID-19 pandemic, healthcare systems were significantly disrupted, potentially affecting timely diagnosis and management of non-COVID conditions such as appendicitis. Delayed presentations may have led to increased complications. This study aimed to compare the frequency of appendicitis complications before and during the pandemic. Methods and Materials: This retrospective cohort study included all patients who underwent appendectomy at Shahid Beheshti Hospital in Kashan between March 2016 and February 2021. Patients were divided into two groups: pre-pandemic (2017–2019) and pandemic (2019–2021). Data including demographic characteristics, complications, and pathology reports were extracted from medical records and analyzed using SPSS version 26. Results: A total of 1,777 appendectomy cases were reviewed; 1,062 (59.7%) were pre-pandemic and 715 (40.3%) during the pandemic. Mean age was 34.2 ± 12.1 and 33.9 ± 14.8 years, respectively (p=0.873). There was no significant difference in gender distribution (p=0.396). Perforation was the most common complication, occurring in 10.3% pre-pandemic and 11.4% during the pandemic. Severe peritonitis was significantly more frequent during the pandemic (p=0.02). Postoperative complications such as drain placement and intra-abdominal abscess occurred similarly in both periods. Pathology revealed non-complicated appendicitis in approximately 80% of cases (p=0.825). Negative appendectomy rates decreased significantly during the pandemic (4.9% vs. 7.4%, p=0.030), while complicated appendicitis showed a non-significant increase (8.8% vs. 7.9%, p=0.269). Conclusion and Discussion: The number of appendectomies decreased during the pandemic, likely due to reallocation of hospital resources. The higher rate of severe peritonitis during the pandemic suggests delayed presentation or treatment. Lower negative appendectomy rates may reflect stricter criteria for surgery during resource-limited times. These findings highlight the indirect impact of the pandemic on acute surgical care and emphasize the need for improved triage strategies during public health crises.
Keywords: Acute appendicitis, COVID-19, appendectomy, complications
