ED visits for appendicitis, miscarriage fell sharply in firs
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Emergency department visits for common conditions such as appendicitis, miscarriage, gallbladder attacks, and ectopic pregnancy decreased markedly at the start of the COVID-19 pandemic, but patient outcomes were not worse, found research published in CMAJ.

The researchers compared emergency department visits over 2 periods, from January 1 to July 1, 2019, and January 1 to June 30, 2020. During this period, there were 39 691 emergency department visits for abdominal and gynecological conditions, including 15 964 for appendicitis, 12 733 for miscarriage, 8457 for gallbladder (cholecystitis), and 2537 (6%) for ectopic pregnancy.

--Emergency department visits declined sharply at the start of the pandemic, with a 20% to 39% reduction in visits for appendicitis and miscarriage.

--Over the total study period, just over half of patients were hospitalized, most for appendicitis.

--Despite fewer emergency department visits, there was no increase in adverse patient outcomes.

"Our study suggests a third possibility: potential over usage of the emergency department before the pandemic," writes the authors. "Avoidance of the emergency department during the pandemic may have resulted in miscarriages being managed through outpatient or virtual clinics without an emergency department visit. For some patients with mild symptoms of uncomplicated appendicitis, their symptoms may have resolved without presenting to the emergency department or they may have used virtual visits for conservative management."

Public messaging about when to seek emergency care and options for alternative care, such as telemedicine and after-hours clinics, could be employed in the future to better use emergency department resources.

Source: https://www.cmaj.ca/content/193/21/E753
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