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Trends in Pediatric Appendicitis and Imaging Strategies During Covid-19 in the United States.
Hayatghaibi, Shireen E; Trout, Andrew T; Dillman, Jonathan R; Callahan, Michael; Iyer, Ramesh; Nguyen, HaiThuy; Riedesel, Erica; Ayyala, Rama S.
  • Hayatghaibi SE; Department of Radiology, Texas Children's Hospital, Houston Texas; University of Texas, School of Public Health, Houston, Texas.
  • Trout AT; Department of Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH; Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio; Department of Radiology, University of Cincinnati College of Medicine, Cincinnati, OH.
  • Dillman JR; Department of Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH; Department of Radiology, University of Cincinnati College of Medicine, Cincinnati, OH.
  • Callahan M; Department of Radiology, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts.
  • Iyer R; Department of Radiology, Seattle Children's Hospital, University of Washington School of Medicine, Seattle, Washington.
  • Nguyen H; Department of Radiology, Texas Children's Hospital, Houston Texas.
  • Riedesel E; Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, Georgia; Division of Pediatric Radiology, Children's Healthcare of Atlanta Division of Pediatric Radiology, Atlanta, Georgia.
  • Ayyala RS; Department of Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH; Department of Radiology, University of Cincinnati College of Medicine, Cincinnati, OH. Electronic address: Rama.ayyala@cchmc.org.
Acad Radiol ; 28(11): 1500-1506, 2021 11.
Article in English | MEDLINE | ID: covidwho-1372843
ABSTRACT
RATIONALE AND

OBJECTIVES:

To determine if, during the first wave of the COVID-19 pandemic, 1) the proportion of complicated appendicitis changed, and 2) if imaging strategies for appendicitis in children changed. MATERIALS AND

METHODS:

Retrospective cross-sectional study using administrative data from the Pediatric Health Information System, inclusive of pediatric patients diagnosed with appendicitis from March to May in 2017, 2018, 2019 and 2020. We compared trends during COVID-19 pandemic (March-May 2020) with corresponding pre-COVID-19 periods in 2017-201.9 Study outcomes were the proportion of complicated appendicitis and trends in imaging for appendicitis explained by patient-level variables.

RESULTS:

The proportion of complicated appendicitis cases increased by 4.4 percentage points, from 46.5% pre-COVID-19 (2017-2019) to 50.9% during COVID-19 (2020), p < 0.001. Mean count of uncomplicated acute appendicitis cases decreased from pre-COVID-19 to the 2020 COVID-19 period (2017 n = 2555; 2018 n = 2679; 2019 n = 2722; 2020 n = 2231). Mean count of complicated appendicitis was unchanged between study periods (2017 n = 2189; 2018 n = 2302, 2019 n = 2442; 2020 n = 2311). Imaging approaches were largely unchanged between study periods; ultrasound was the most utilized modality in both study periods (68.3%, 70.2%; p = 0.033).

CONCLUSION:

During the first wave of the COVID-19 pandemic, the proportion of complicated appendicitis cases increased without an absolute increase in the number of complicated appendicitis cases, but instead a decrease in the number of uncomplicated acute appendicitis diagnoses.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Appendicitis / COVID-19 Type of study: Observational study / Randomized controlled trials Limits: Child / Humans Country/Region as subject: North America Language: English Journal: Acad Radiol Journal subject: Radiology Year: 2021 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Appendicitis / COVID-19 Type of study: Observational study / Randomized controlled trials Limits: Child / Humans Country/Region as subject: North America Language: English Journal: Acad Radiol Journal subject: Radiology Year: 2021 Document Type: Article