COVID-19-specific risk factor for early post-appendectomy complications (EPAC) in older patients: a retrospective study - Scorecard - MDSpire

COVID-19-specific risk factor for early post-appendectomy complications (EPAC) in older patients: a retrospective study

  • By

  • Tamer A. A. M. Habeeb

  • A. Hussain

  • Jose Bueno-Lledó

  • M. E. Giménez

  • A. Aiolfi

  • M. Chiaretti

  • I. A. Kryvoruchko

  • M. N. Manangi

  • Abd Al-Kareem Elias

  • Abdelmonem A.M Adam

  • Mohamed A. Gadallah

  • Saad Mohamed Ali Ahmed

  • Ahmed Khyrallh

  • Mohammed H. Alsayed

  • Esmail Tharwat Kamel Awad

  • Emad A. Ibrahim

  • Mohammed Hassan Elshafey

  • Mohamed fathy Labib

  • Mahmoud Hassib Morsi Badawy

  • Sobhy rezk ahmed Teama

  • Abdelhafez Seleem

  • Mohamed Ibrahim Abo Alsaad

  • Abouelatta KH Ali

  • Hamdi Elbelkasi

  • Mahmoud Ali abou zaid

  • Basma Ahmed Mohamed

  • Alaa Alwadees

  • Ahmed k. El-Taher

  • Mohamed Ibrahim Mansour

  • Mahmoud Abdou Yassin

  • Ahmed Salah Arafa

  • Mohamed Lotfy

  • Baher Atef

  • Mohamed Elnemr

  • Mostafa M Khairy

  • Abdelfatah H. Abdelwanis

  • ahmed mesbah Abdelaziz

  • Abdelshafy Mostafa

  • AbdElwahab M. Hamed

  • Tamer Wasefy

  • Ibrahim A. Heggy

  • Abdelrahman Mohamed Hasanin Nawar

  • November 5, 2025

  • 0 min

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Clinical Scorecard: Identifying COVID-19-related risk factors for early complications following appendectomy in elderly patients: a retrospective analysis

At a Glance

CategoryDetail
ConditionAcute appendicitis (AA) in elderly patients
Key MechanismsDelayed diagnosis and frailty increase risk of complications such as perforation, gangrene, abscess, and peritonitis; COVID-19 infection may influence postoperative complications
Target PopulationOlder patients aged ≥ 60 years undergoing appendectomy
Care SettingTertiary care centers and teaching hospitals managing emergency appendectomies

Key Highlights

  • Older patients with AA often present atypically, causing diagnostic delays and higher complication rates.
  • COVID-19 pandemic influenced surgical approaches, with some preference for open appendectomy to reduce viral aerosolization.
  • No prior data specifically evaluate early post-appendectomy complications (EPAC) and COVID-19 infection risk factors in elderly patients.

Guideline-Based Recommendations

Diagnosis

  • Diagnose AA based on clinical, radiological, and operative findings, confirmed by histopathology.
  • Use pelvic–abdominal CT in uncertain cases to exclude other pathologies, especially malignancies.

Management

  • Perform appendectomy (open or laparoscopic) in elderly patients with confirmed AA.
  • Manage localized appendicular abscesses with radiological drainage and antibiotics; surgical drainage if radiological drainage fails or abscess is undiagnosed preoperatively.
  • Consider interval appendectomy after successful abscess drainage.

Monitoring & Follow-up

  • Monitor for early post-appendectomy complications including surgical site infections, intra-abdominal abscesses, and ileus within 30 days post-surgery.

Risks

  • Recognize increased risk of complications with delayed diagnosis, frailty, comorbidities, and active COVID-19 infection during hospital admission.

Patient & Prescribing Data

Elderly patients (≥ 60 years) undergoing emergency appendectomy during and after the COVID-19 pandemic

Surgical approach and postoperative outcomes may be influenced by COVID-19 status; careful assessment of frailty and comorbidities is essential for risk stratification.

Clinical Best Practices

  • Assess frailty using Clinical Frailty Scale (CFS) and comorbidity burden using age-adjusted Charlson Comorbidity Index (CCI) preoperatively.
  • Obtain preoperative consent and adhere to ethical guidelines including Declaration of Helsinki and STROCSS statement.
  • Adapt surgical approach considering COVID-19 infection risk and institutional protocols to minimize viral transmission.
  • Use multidisciplinary teams in tertiary centers to manage complex elderly patients with AA.

References

Original Source(s)

COVID-19-specific risk factor for early post-appendectomy complications (EPAC) in older patients: a retrospective study

  • by Tamer A. A. M. Habeeb, A. Hussain, Jose Bueno-Lledó, M. E. Giménez, A. Aiolfi, M. Chiaretti, I. A. Kryvoruchko, M. N. Manangi, Abd Al-Kareem Elias, Abdelmonem A.M Adam, Mohamed A. Gadallah, Saad Mohamed Ali Ahmed, Ahmed Khyrallh, Mohammed H. Alsayed, Esmail Tharwat Kamel Awad, Emad A. Ibrahim, Mohammed Hassan Elshafey, Mohamed fathy Labib, Mahmoud Hassib Morsi Badawy, Sobhy rezk ahmed Teama, Abdelhafez Seleem, Mohamed Ibrahim Abo Alsaad, Abouelatta KH Ali, Hamdi Elbelkasi, Mahmoud Ali abou zaid, Basma Ahmed Mohamed, Alaa Alwadees, Ahmed k. El-Taher, Mohamed Ibrahim Mansour, Mahmoud Abdou Yassin, Ahmed Salah Arafa, Mohamed Lotfy, Baher Atef, Mohamed Elnemr, Mostafa M Khairy, Abdelfatah H. Abdelwanis, ahmed mesbah Abdelaziz, Abdelshafy Mostafa, AbdElwahab M. Hamed, Tamer Wasefy, Ibrahim A. Heggy, Abdelrahman Mohamed Hasanin Nawar

  • November 5, 2025

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