TY  - JOUR
A1  - Maneck, Matthias
A1  - Günster, Christian
A1  - Meyer, Hans-Joachim
A1  - Heidecke, Claus-Dieter
A1  - Rolle, Udo
T1  - Influence of COVID-19 confinement measures on appendectomies in Germany - a claims data analysis of 9797 patients
T2  - Langenbeck's archives of surgery
N2  - Purpose: COVID-19 pandemic had multiple influences on the social, industrial, and medical situation in all affected countries. Measures of obligatory medical confinement were suspensions of scheduled non-emergent surgical procedures and outpatients’ clinics as well as overall access restrictions to hospitals and medical practices. The aim of this retrospective study was to assess if the obligatory confinement (lockdown) had an effect on the number of appendectomies (during and after the period of lockdown).
Methods: This retrospective study was based on anonymized nationwide administrative claims data of the German Local General Sickness Fund (AOK). Patients admitted for diseases of the appendix (ICD-10: K35-K38) or abdominal and pelvic pain (ICD-10: R10) who underwent an appendectomy (OPS: 5-470) were included. The study period included 6 weeks of German lockdown (16 March–26 April 2020) as well as 6 weeks before (03 February–15 March 2020) and after (27 April–07 June 2020). These periods were compared to the respective one in 2018 and 2019.
Results: The overall number of appendectomies was significantly reduced during the lockdown time in 2020 compared to that in 2018 and 2019. This decrease affects only appendectomies due to acute simple (ICD-10: K35.30, K35.8) and non-acute appendicitis (ICD-10: K36-K38, R10). Numbers for appendectomies in acute complex appendicitis remained unchanged. Female patients and in the age group 1–18 years showed the strongest decrease in number of cases.
Conclusion: The lockdown in Germany resulted in a decreased number of appendectomies. This affected mainly appendectomies in simple acute and non-acute appendicitis, but not complicated acute appendicitis. The study gives no evidence that the confinement measures resulted in a deterioration of medical care for appendicitis.
KW  - COVID 19 pandemic
KW  - Confinement
KW  - Lockdown
KW  - Appendectomy
KW  - Administrative claims data
Y1  - 2020
UR  - http://publikationen.ub.uni-frankfurt.de/frontdoor/index/index/docId/80738
UR  - https://nbn-resolving.org/urn:nbn:de:hebis:30:3-807381
SN  - 1435-2451
N1  - Open Access funding enabled and organized by Projekt DEAL.
N1  - Data availability
The authors confirm that the data utilized in this study cannot be made available in the manuscript, the supplemental files, or in a public repository due to German data protection laws (“Bundesdatenschutzgesetz,” BDSG). Therefore, they are stored on a secure drive in the AOK Research Institute (WIdO), to facilitate replication of the results. Generally, access to data of statutory health insurance funds for research purposes is possible only under the conditions defined in German Social Law (SGB V § 287). Requests for data access can be sent as a formal proposal specifying the recipient and purpose of the data transfer to the appropriate data protection agency. Access to the data used in this study can only be provided to external parties under the conditions of the cooperation contract of this research project and after written approval by the sickness fund. For assistance in obtaining access to the data, please contact christian.guenster[at]wido.bv.aok.de.
VL  - 406
IS  - 2
SP  - 385
EP  - 391
PB  - Springer
CY  - Berlin ; Heidelberg
ER  -