Marjorie N Odegard, Olivia A Keane, Shadassa A Ourshalimian, Christopher J Russell, William G Lee, Makayla L O'Guinn, Laura M C Houshmand, Lorraine I Kelley-Quon
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Children with documented COVID-19 were identified. Exclusions included preoperative ventilator or supplemental oxygen dependence, and missing data. To evaluate COVID-19 positive versus COVID-19 negative patients, we used a propensity score matched on sociodemographics, comorbidities, laparoscopy, perforation, and hospital. Chi-square and Mann-Whitney U tests identified differences between groups in length of stay, postoperative drain placement, 30-day re-admission, and mechanical ventilation requirements.</p><p><strong>Results: </strong>Overall, 51,861 children of median age 11y (IQR: 8-14) underwent appendectomy, of whom 1,440 (2.3%) had COVID-19. Most were male (60.3%), White (72.1%) and non-Hispanic (61.4%). Public insurance was the most common (47.5%). We created a matched cohort of 1,360 COVID-19 positive and 1,360 COVID-19 negative children. 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引用次数: 0
摘要
目的：COVID-19 流行初期，许多同时患有阑尾炎和 COVID-19 的儿童最初接受非手术治疗，后来又接受了间隔性阑尾切除术。目前，同时患有阑尾炎和 COVID-19 的儿童经常接受前期阑尾切除术。恢复前期手术治疗对患者预后的影响尚不清楚。本研究比较了感染和未感染 COVID-19 的儿童患者接受阑尾切除术后的疗效：研究设计：一项儿童回顾性队列研究：总计51,861名中位数年龄为11岁（IQR：8-14）的儿童接受了阑尾切除术，其中1,440人（2.3%）感染了COVID-19。大多数为男性（60.3%）、白人（72.1%）和非西班牙裔（61.4%）。最常见的是公共保险（47.5%）。我们建立了一个由 1,360 名 COVID-19 阳性儿童和 1,360 名 COVID-19 阴性儿童组成的匹配队列。COVID-19阳性患儿的住院时间较短（1d，IQR：1-4 vs. 2d，IQR：1-5，p = 0.03），术后腹腔引流管置入率较低（2.4% vs. 4.1%，p = 0.01），30天再住院率较低（9.0% vs. 11.4%，p = 0.04）。然而，在机械通气的发生率或持续时间方面没有发现差异（p > 0.05）：结论：我们的研究结果表明，对患有阑尾炎和COVID-19的儿童进行前期阑尾切除术的结果与没有COVID-19的儿童相似：证据等级：三级。
Clinical outcomes of children with COVID-19 and appendicitis: a propensity score matched analysis.
Objective: Early in the COVID-19 pandemic, many children with appendicitis and COVID-19 were initially treated non-operatively and later underwent interval appendectomy. Currently, children with both appendicitis and COVID-19 frequently undergo upfront appendectomy. The impact of this return to upfront surgical management on patient outcomes is unknown. This study compared outcomes of pediatric patients with and without COVID-19 infection undergoing appendectomy.
Study design: A retrospective cohort study of children < 21y who underwent appendectomy from 3/19/2020 to 7/31/2022 at 50 Pediatric Health Information System children's hospitals was conducted. Children with documented COVID-19 were identified. Exclusions included preoperative ventilator or supplemental oxygen dependence, and missing data. To evaluate COVID-19 positive versus COVID-19 negative patients, we used a propensity score matched on sociodemographics, comorbidities, laparoscopy, perforation, and hospital. Chi-square and Mann-Whitney U tests identified differences between groups in length of stay, postoperative drain placement, 30-day re-admission, and mechanical ventilation requirements.
Results: Overall, 51,861 children of median age 11y (IQR: 8-14) underwent appendectomy, of whom 1,440 (2.3%) had COVID-19. Most were male (60.3%), White (72.1%) and non-Hispanic (61.4%). Public insurance was the most common (47.5%). We created a matched cohort of 1,360 COVID-19 positive and 1,360 COVID-19 negative children. Children with COVID-19 had shorter hospitalizations (1d, IQR: 1-4 vs. 2d, IQR: 1-5, p = 0.03), less postoperative peritoneal drain placement (2.4% vs. 4.1%, p = 0.01), and fewer 30-day readmissions (9.0% vs. 11.4%, p = 0.04). However, no difference in incidence or duration of mechanical ventilation (p > 0.05) was detected.
Conclusions: Our findings suggest that upfront appendectomy for children with appendicitis and COVID-19 has similar outcomes compared to children without COVID-19.
期刊介绍：
Pediatric Surgery International is a journal devoted to the publication of new and important information from the entire spectrum of pediatric surgery. The major purpose of the journal is to promote postgraduate training and further education in the surgery of infants and children.
The contents will include articles in clinical and experimental surgery, as well as related fields. One section of each issue is devoted to a special topic, with invited contributions from recognized authorities. Other sections will include:
-Review articles-
Original articles-
Technical innovations-
Letters to the editor
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