Observational Study
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Aug 27, 2021; 13(8): 859-870
Published online Aug 27, 2021. doi: 10.4240/wjgs.v13.i8.859
Impact of COVID-19 on presentation, management, and outcomes of acute care surgery for gallbladder disease and acute appendicitis
Orly Nadell Farber, Giselle I Gomez, Ashley L Titan, Andrea T Fisher, Christopher J Puntasecca, Veronica Toro Arana, Arielle Kempinsky, Clare E Wise, Kovi E Bessoff, Mary T Hawn, James R Korndorffer Jr, Joseph D Forrester, Micaela M Esquivel
Orly Nadell Farber, Giselle I Gomez, Ashley L Titan, Andrea T Fisher, Christopher J Puntasecca, Veronica Toro Arana, Arielle Kempinsky, Clare E Wise, Kovi E Bessoff, Mary T Hawn, James R Korndorffer Jr, Joseph D Forrester, Micaela M Esquivel, Department of Surgery, Stanford University School of Medicine, Palo Alto, CA 94305, United States
Author contributions: Esquivel MM, Titan AL, Hawn MT, Bessoff KE, Korndorffer JR Jr, and Forrester JD designed the study; Farber ON, Gomez GI, Fisher AT, Puntasecca CJ, Arana VT, Kempinsky A, Wise CE collected and interpreted the data; Gomez GI and Arana VT performed statistical analyses; Farber ON, Gomez GI, Titan AL, Fisher AT, Puntasecca CJ wrote the manuscript; all authors read and approved the final manuscript.
Institutional review board statement: The study was reviewed and approved by the Stanford University Institutional Review Board, No. 56347.
Informed consent statement: This retrospective chart review study is exempt from requiring informed consent.
Conflict-of-interest statement: There are no conflicts of interest to report.
Data sharing statement: Technical appendix, statistical code, and dataset available from the corresponding author at mesquive@stanford.edu. No additional data are available.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Micaela M Esquivel, MD, Assistant Professor, Department of Surgery, Stanford University School of Medicine, 900 Blake Wilbur Dr, Palo Alto, CA 94305, United States. mesquive@stanford.edu
Received: April 1, 2021
Peer-review started: April 1, 2021
First decision: May 13, 2021
Revised: May 31, 2021
Accepted: July 9, 2021
Article in press: July 9, 2021
Published online: August 27, 2021
ARTICLE HIGHLIGHTS
Research background

Data from the early months of the coronavirus disease 2019 (COVID-19) pandemic suggest that acute care patient populations deferred presenting to the emergency department (ED), portending more severe disease at the time of presentation. Additionally, care for this patient population trended towards initial non-operative management.

Research motivation

The ongoing COVID-19 pandemic has significantly disrupted both elective and acute medical care. Understanding the pandemic’s impact on acute care surgery patients can help inform responses to future COVID-19 surges or other public health crises.

Research objectives

The aim of this study was to examine the presentation, management, and outcomes of patients who developed gallbladder disease or appendicitis during the pandemic.

Research methods

A retrospective chart review of patients diagnosed with acute cholecystitis, symptomatic cholelithiasis, or appendicitis in two EDs affiliated with a single tertiary academic medical center in Northern California between March and June, 2020 and in the same months of 2019.

Research results

Patients with gallbladder disease and appendicitis both had more severe presentations during the pandemic in 2020 as compared to the year prior.

Research conclusions

The pandemic has affected patients with acute surgical conditions.

Research perspectives

These findings can inform policy and public messaging surrounding stay-at-home orders and access to care during future COVID-19 surges.