Impact of COVID-19 on presentation, management, and outcomes of acute care surgery for gallbladder disease and acute appendicitis

Table 4 Appendicitis presentation, management, and operative findings

	Appendicitis
	March–June 2019		March–June 2020		P value
	182		179
Alvarado score, mean (SD)	6.53	1.82	6.50	1.89	0.63
Ruptured appendix, n (%) at diagnosis	29	16%	36	20%	0.02
Ruptured appendix, n (%) post op	43	23%	41	23%	0.68
Symptom duration prior to ED (d), mean (SD)	2.72	7.23	2.19	3.12	0.36
ED severity score, mean (SD)	2.87	0.33	2.37	0.49	< 0.0001
Resucitation, n (%))	0	0%	0	0%
Emergent, n (%)	23	13%	112	63%
Non-emergent, n (%)	159	87%	67	37%
ED length of stay (h), median (IQR)	5.00	3.5–6.6	6.00	4–7	0.51
Disposition from ED					0.57
Discharged, n (%)	3	2%	3	2%
Discharged with urgent follow up, n (%)	0	0%	1	1%
Admitted, n (%)	174	96%	173	97%
Underwent surgical procedure, n (%)	150	82%	156	87%	0.47
Laparoscopic appendectomy	145	97%	149	96%
Laparoscopic converted to open appendectomy	2	1%	1	1%
Right hemicolectomy	2	1%	0	0%
Percutaneous abscess drain (IR)	1	1%	6	4%
Post-op diagnosis, n (%)
Ruptured appendix	43	29%	41	26%	0.68
Appendix not ruptured	106	71%	116	74%
Time from presentation to OR (h), median (IQR)	11.2	6–17	11.0	6–17	0.38
Drains left in place post op, n (%)	6	4%	11	7%	0.07
Patients with additional procedures, n (%)	17	11%	11	7%	0.27
Draining of abscess	7	41%	2	18%
Bowel resection	2	12%	0	0%
Drain placement	3	18%	1	9%
PICC line	1	6%	2	18%
NGT placement	0	0%	2	18%

ED: Emergency departments; OR: Odds ratios; PICC: Peripherally inserted central catheters; IR: Immunoreactive; NGT: Nasogastric tube.