An observational study in Postoperative Complications, Appendicitis and COVID-19 Pandemic, sponsored by Central Hospital, Nancy, France. Completed at 1 site in France. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2025-02-13.
Sponsored by Central Hospital, Nancy, France · Observational
There are 2 types of surgical procedures to remove the appendix : open appendectomy or laparoscopic appendectomy. About 60000 appendectomies are performed every year in France. Early diagnosis of acute appendicitis is essential to prevent the risk of disease progression, leading to complicated appendicitis and an increased risk for mortality. Data regarding appendicitis management in the literature are numerous. However, the impact of COVID-19 pandemic on the management of those patients has led to a decrease in the number of visits for acute appendicitis (ER), but a higher proportion of complicated appendicitis, probably due to the patient's delayed decision to go to emergency department at the onset of clinical symptoms. Complicated appendicitis may also lead to an overuse of antibiotics, a longer hospital stay, and a higher global cost for the health system. This aim of this study was to evaluate whether this hypothesis was valid for the regional NANCY-METZ area (CHR Metz and CHRU Nancy). The main research hypothesis was that the pandemic caused by SARS-COVID 19 was significantly linked to an increased incidence of perioperative complications in patients who underwent an appendectomy for acute appendicitis in this region (North-east part of France).
Appendix is a finger-like, blind-ended tube connected to the cecum. The most frequent disease regarding the appendix is appendicitis. Appendicitis is an inflammation of the appendix caused by an obstruction of the lumen of the appendix. This obstruction is most commonly due to an appendicolith (calcified "stone" made of feces). Inflamed lymphoid tissue from a viral infection, parasites, gallstone, or tumors may also cause the blockage. This blockage leads to an increased pressure in the appendix, leading to a decreased blood flow to the tissues of the appendix, and bacterial growth inside the appendix causing inflammation. The combination of inflammation, reduced blood flow to the appendix and distention of the appendix causes tissue injury and lead to infection and potentially necrosis. If this process is left untreated, the appendix may burst, releasing bacteria into the abdominal cavity, leading to a peritonitis with a potential impact on mortality rate. Appendicitis symptoms include right lower abdominal pain, nausea, vomiting, and decreased appetite. Complicated appendicitis is defined as perforated appendicitis, peri-appendicular abscess or peritonitis. Consequently, acute appendicitis is considered to be a surgical emergency.
There are 2 types of surgical procedures to remove the appendix : open appendectomy or laparoscopic appendectomy. About 60000 appendectomies are performed every year in France. Early diagnosis of acute appendicitis is essential to prevent the risk of disease progression, leading to complicated appendicitis and an increased risk for mortality. Data regarding appendicitis management in the literature are numerous. However, the impact of COVID-19 pandemic on the management of those patients has led to a decrease in the number of visits for acute appendicitis (ER), but a higher proportion of complicated appendicitis, probably due to the patient's delayed decision to go to emergency department at the onset of clinical symptoms. Complicated appendicitis may also lead to an overuse of antibiotics, a longer hospital stay, and a higher global cost for the health system. This aim of this study was to evaluate whether this hypothesis was valid for the regional NANCY-METZ area (CHR Metz and CHRU Nancy). The main research hypothesis was that the pandemic caused by SARS-COVID 19 was significantly linked to an increased incidence of perioperative complications in patients who underwent an appendectomy for acute appendicitis in this region (North-east part of France).
1,332 studies on the registry are indexed under Postoperative Complications; 311 are open to participants now.
This study's enrollment of 300 is above the median of 251 across 537 observational studies indexed under Postoperative Complications.
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Patients managed at :
and who underwent appendectomy during the study period
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Exclusion Criteria:
- Patients who underwent an appendectomy from March 17, 2018 to December 14, 2018 and from March 17, 2019 to December 14, 2019
Procedure: appendectomy
- Patients who underwent an appendectomy from March 17, 2020 to December 14, 2020
Procedure: appendectomy
appendectomy for acute appendicitis
Perioperative complications after appendectomy
validated classification (Gomes classification)
Time frame: from March 17 to December 14 (2020-2021 versus 2019-2018)
Postoperative complications after appendectomy
validated classification (Clavien Dindo classification)
Time frame: from March 17 to December 14 (2020-2021 versus 2019-2018)
Delay before surgery
Time duration from Symptoms onset and appendectomy
Time frame: from March 17 to December 14 (2020-2021 versus 2019-2018)
Hospitalization duration
Hospitalization duration
Time frame: from March 17 to December 14 (2020-2021 versus 2019-2018)
Antibiotherapy duration
Total antibiotherapy duration
Time frame: from March 17 to December 14 (2020-2021 versus 2019-2018)
Biological inflammatory syndrom
Hyperleucocytosis \> 10000/mm3 and/or PCR \> 100 mg/L
Time frame: from March 17 to December 14 (2020-2021 versus 2019-2018)
Type of hospitalisation
ward / ICU
Time frame: from March 17 to December 14 (2020-2021 versus 2019-2018)
Delay between appedectomy and postoperative complications
\< 7 days; 7-30 days; \> 30 days
Time frame: from March 17 to December 14 (2020-2021 versus 2019-2018)
Plan to share: No
This study is completed, as verified in Feb 2025. You cannot join it, but the record below documents what was studied.
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