TY - JOUR
T1 - Clinical Presentation of Acute Cholecystitis during the COVID-19 Outbreak
AU - Hershkovitz, Yehuda
AU - Zmora, Oded
AU - Nativ, Hilli
AU - Ashkenazi, Itamar
AU - Hammerschlag, Jonathan
AU - Jeroukhimov, Igor
N1 - Publisher Copyright:
© 2022 Israel Medical Association. All rights reserved.
PY - 2022/5/1
Y1 - 2022/5/1
N2 - Background: The coronavirus disease 2019 (COVID-19) pandemic has had a significant impact on healthcare systems worldwide. The fear of seeking medical attention to avoid the possibility of being infected may have altered the course of some diseases. Objectives: To describe our experience with the management of patients with acute cholecystitis during the pandemic at our medical center. Methods: We compared patients treated for acute cholecystitis between 1 March and 31 August 2020 (Group I) to patients admitted with the same diagnosis during the same months in 2019 (Group II). We evaluated demographics, presenting symptoms, laboratory and imaging findings at presentation, the disease's clinical course, management, and outcome. Results: Group I consisted of 101 patients and group II included 94 patients. No differences were noted for age (66 years, IQR 48-78 vs. 66 years, IQR 47-76; P = 0.50) and sex (57.4% vs. 51.1% females; P = 0.39) between the two groups. The delay between symptom onset and hospital admission was longer for Group I patients (3 days, IQR 2-7 vs. 2 days, IQR 1-3; P = 0.002). Moderate to severe disease was more commonly encountered in Group I (59.4% vs. 37.2%, P = 0.003). Group I patients more often failed conservative management (36% vs. 6%, P = 0.001) and had a higher conversion rate to open surgery (15.4% vs. 0%, P = 0.025). Conclusions: Patients presenting with acute cholecystitis during the COVID-19 pandemic more often presented late to the emergency department and more showed adverse outcomes.
AB - Background: The coronavirus disease 2019 (COVID-19) pandemic has had a significant impact on healthcare systems worldwide. The fear of seeking medical attention to avoid the possibility of being infected may have altered the course of some diseases. Objectives: To describe our experience with the management of patients with acute cholecystitis during the pandemic at our medical center. Methods: We compared patients treated for acute cholecystitis between 1 March and 31 August 2020 (Group I) to patients admitted with the same diagnosis during the same months in 2019 (Group II). We evaluated demographics, presenting symptoms, laboratory and imaging findings at presentation, the disease's clinical course, management, and outcome. Results: Group I consisted of 101 patients and group II included 94 patients. No differences were noted for age (66 years, IQR 48-78 vs. 66 years, IQR 47-76; P = 0.50) and sex (57.4% vs. 51.1% females; P = 0.39) between the two groups. The delay between symptom onset and hospital admission was longer for Group I patients (3 days, IQR 2-7 vs. 2 days, IQR 1-3; P = 0.002). Moderate to severe disease was more commonly encountered in Group I (59.4% vs. 37.2%, P = 0.003). Group I patients more often failed conservative management (36% vs. 6%, P = 0.001) and had a higher conversion rate to open surgery (15.4% vs. 0%, P = 0.025). Conclusions: Patients presenting with acute cholecystitis during the COVID-19 pandemic more often presented late to the emergency department and more showed adverse outcomes.
KW - acute cholecystitis
KW - cholecystectomy
KW - coronavirus disease 2019 (COVID-19)
UR - http://www.scopus.com/inward/record.url?scp=85130864179&partnerID=8YFLogxK
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C2 - 35598054
AN - SCOPUS:85130864179
SN - 1565-1088
VL - 24
SP - 306
EP - 309
JO - Israel Medical Association Journal
JF - Israel Medical Association Journal
IS - 5
ER -