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ED Presentations for Appendicitis, Miscarriage Down in Pandemic

During pandemic, initial reduction seen in ED visits for cholecystitis, ectopic pregnancy; reductions sustained for appendicitis, miscarriage

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FRIDAY, May 28, 2021 (HealthDay News) -- During the COVID-19 pandemic, there was a decrease in presentations to the emergency department for appendicitis and miscarriage, according to a study published online May 25 in CMAJ, the journal of the Canadian Medical Association.

David Gomez, M.D., Ph.D., from St. Michael's Hospital in Toronto, and colleagues assessed the weekly rate of emergency department visits from Jan. 1 to March 10, 2020, and from March 11 to June 30, 2020, compared with a historical control period (Jan. 1 to July 1, 2019). Weekly incidence rate ratios of emergency department visits, management strategies, and clinical outcomes were evaluated for patients presenting with appendicitis, cholecystitis, ectopic pregnancy, or miscarriage. Data were included for 39,691 emergency department visits across all study periods.

The researchers observed an initial reduction in emergency department visits for presentations of cholecystitis and ectopic pregnancy; however, they rapidly returned to expected levels. Sustained reductions were seen for presentations for appendicitis and miscarriage (incidence rate ratio, 0.61 to 0.80), with 1,087 and 984 fewer visits, respectively, after the start of the pandemic compared with 2019. For all conditions, management strategies, complications, and mortality rates were similar across study periods.

"These findings are reassuring, as patients who required emergency care in the first wave of the pandemic continued to present to the emergency department, received similar care, and had similar outcomes to patients presenting in the prepandemic period," the authors write.

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