Analyzing the dynamics of complicated and uncomplicated appendicitis during the COVID-19 pandemic in Seoul, Korea: a multifaceted time series approach

OBJECTIVES This study investigated the impact of the coronavirus disease 2019 (COVID-19) pandemic and associated control strategies on the incidence of appendicitis in Seoul, using data from 2018 to 2020 from Korea’s National Health Insurance. METHODS We analyzed records of total, complicated, and u...

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Main Authors: Kiook Baek, Chulyong Park
Format: Article
Language:English
Published: Korean Society of Epidemiology 2024-10-01
Series:Epidemiology and Health
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Online Access:http://www.e-epih.org/upload/pdf/epih-46-e2024081.pdf
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author Kiook Baek
Chulyong Park
author_facet Kiook Baek
Chulyong Park
author_sort Kiook Baek
collection DOAJ
description OBJECTIVES This study investigated the impact of the coronavirus disease 2019 (COVID-19) pandemic and associated control strategies on the incidence of appendicitis in Seoul, using data from 2018 to 2020 from Korea’s National Health Insurance. METHODS We analyzed records of total, complicated, and uncomplicated appendicitis cases, as well as the ratio of complicated to uncomplicated appendicitis, using natural spline and piecewise regression models to identify trends and breakpoints. Bayesian structural time-series (BSTS) models were used to evaluate the causal impact of social distancing on appendicitis incidences. RESULTS The spline regression analysis indicated decreasing trends in both total and uncomplicated appendicitis cases. Conversely, the incidence of complicated appendicitis and the ratio of complicated to uncomplicated cases increased. Breakpoints for a decline in uncomplicated appendicitis and a rise in the ratio occurred at 31 weeks in 2020 (95% confidence interval [CI], 23.2 to 38.8) and at 33.9 weeks (95% CI, 28.3 to 39.6), respectively. The BSTS model demonstrated a 7.8% reduction in total appendicitis cases (95% credible interval [CrI], -12.1 to -3.3). It also showed a 17.4% decrease in uncomplicated cases (95% CrI, -22.2 to -12.3) and increases of 12.8% (95% CrI, 4.9 to 22.0) in complicated cases and 39.0% (95% CrI, 27.0 to 53.3) in the ratio of complicated to uncomplicated appendicitis. CONCLUSIONS The COVID-19 pandemic resulted in a decrease in both total and uncomplicated appendicitis cases, while the number of complicated cases increased. Reduced medical visits likely accounted for these changes. Strategies are needed to manage changes in disease pathophysiology resulting from altered healthcare utilization during health crises.
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spelling doaj-art-7fa10bcfd0d34c7488f30210f9a2b3ca2025-08-20T03:12:36ZengKorean Society of EpidemiologyEpidemiology and Health2092-71932024-10-014610.4178/epih.e20240811547Analyzing the dynamics of complicated and uncomplicated appendicitis during the COVID-19 pandemic in Seoul, Korea: a multifaceted time series approachKiook Baek0Chulyong Park1 Department of Preventive Medicine, Dongguk University College of Medicine, Gyeongju, Korea Department of Occupational and Environmental Medicine, Yeungnam University Hospital, Daegu, KoreaOBJECTIVES This study investigated the impact of the coronavirus disease 2019 (COVID-19) pandemic and associated control strategies on the incidence of appendicitis in Seoul, using data from 2018 to 2020 from Korea’s National Health Insurance. METHODS We analyzed records of total, complicated, and uncomplicated appendicitis cases, as well as the ratio of complicated to uncomplicated appendicitis, using natural spline and piecewise regression models to identify trends and breakpoints. Bayesian structural time-series (BSTS) models were used to evaluate the causal impact of social distancing on appendicitis incidences. RESULTS The spline regression analysis indicated decreasing trends in both total and uncomplicated appendicitis cases. Conversely, the incidence of complicated appendicitis and the ratio of complicated to uncomplicated cases increased. Breakpoints for a decline in uncomplicated appendicitis and a rise in the ratio occurred at 31 weeks in 2020 (95% confidence interval [CI], 23.2 to 38.8) and at 33.9 weeks (95% CI, 28.3 to 39.6), respectively. The BSTS model demonstrated a 7.8% reduction in total appendicitis cases (95% credible interval [CrI], -12.1 to -3.3). It also showed a 17.4% decrease in uncomplicated cases (95% CrI, -22.2 to -12.3) and increases of 12.8% (95% CrI, 4.9 to 22.0) in complicated cases and 39.0% (95% CrI, 27.0 to 53.3) in the ratio of complicated to uncomplicated appendicitis. CONCLUSIONS The COVID-19 pandemic resulted in a decrease in both total and uncomplicated appendicitis cases, while the number of complicated cases increased. Reduced medical visits likely accounted for these changes. Strategies are needed to manage changes in disease pathophysiology resulting from altered healthcare utilization during health crises.http://www.e-epih.org/upload/pdf/epih-46-e2024081.pdfcovid-19appendicitisappendectomyseoul
spellingShingle Kiook Baek
Chulyong Park
Analyzing the dynamics of complicated and uncomplicated appendicitis during the COVID-19 pandemic in Seoul, Korea: a multifaceted time series approach
Epidemiology and Health
covid-19
appendicitis
appendectomy
seoul
title Analyzing the dynamics of complicated and uncomplicated appendicitis during the COVID-19 pandemic in Seoul, Korea: a multifaceted time series approach
title_full Analyzing the dynamics of complicated and uncomplicated appendicitis during the COVID-19 pandemic in Seoul, Korea: a multifaceted time series approach
title_fullStr Analyzing the dynamics of complicated and uncomplicated appendicitis during the COVID-19 pandemic in Seoul, Korea: a multifaceted time series approach
title_full_unstemmed Analyzing the dynamics of complicated and uncomplicated appendicitis during the COVID-19 pandemic in Seoul, Korea: a multifaceted time series approach
title_short Analyzing the dynamics of complicated and uncomplicated appendicitis during the COVID-19 pandemic in Seoul, Korea: a multifaceted time series approach
title_sort analyzing the dynamics of complicated and uncomplicated appendicitis during the covid 19 pandemic in seoul korea a multifaceted time series approach
topic covid-19
appendicitis
appendectomy
seoul
url http://www.e-epih.org/upload/pdf/epih-46-e2024081.pdf
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