{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,18]],"date-time":"2025-12-18T10:01:52Z","timestamp":1766052112777,"version":"3.48.0"},"reference-count":44,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,11,5]],"date-time":"2025-11-05T00:00:00Z","timestamp":1762300800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,11,5]],"date-time":"2025-11-05T00:00:00Z","timestamp":1762300800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100007102","name":"Zagazig University","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100007102","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Tech Coloproctol"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The incidence of acute appendicitis in older patients significantly varies from that in younger adults. The coronavirus disease 2019 (COVID-19) pandemic has increased the risk of early post-appendectomy complications (EPAC). This study aimed to investigate the incidence and risk factors associated with EPAC in older patients after appendectomy and to define active COVID-19 infection during surgery as an associated risk factor for EPAC.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a retrospective multicenter analysis of older patients aged \u2265\u200960 years who underwent appendectomy between April 2020 and December 2024. Logistic regression identified the risk factors associated with EPAC.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 585 patients aged \u2265\u200960\u00a0years were divided into the EPAC (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200932) and no EPAC (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009553) groups. The incidences of EPAC was 5.5% (32\/585), including superficial incisional surgical site infections (SSI) (9\/32, 28.1%), deep incisional SSI (2\/32, 6.3%), organ\/space infection (2\/32, 6.3%), intra-abdominal abscess (9\/32, 28.1%), ileus (2\/32, 6.3%), pneumonia (3\/32, 9.4%), acute myocardial infraction (MI) (2\/32, 6.3%), fecal fistula (2\/32, 6.3%), and acute adhesive intestinal obstruction (1\/32, 3.1%). Multivariable analysis identified that active COVID-19 infection during surgery (odds ratio (OR)\u2009=\u200925.9; 95% confidence interval (CI) 4.8\u2013139.1;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), American Society of Anesthesiologists (ASA) score\u2009\u2265\u2009II (OR\u2009=\u20094.5; 95% CI 1.2\u201317.07;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.02), open approach (OR\u2009=\u200930.6; 95% CI 8.1\u2013115.3;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), and high-grade appendicitis\u2009\u2265\u2009IV (OR\u2009=\u200963.06; 95% CI 7.5\u2013526.4;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) were significant associated risk factors for EPAC.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The incidence of EPAC in older patients after appendectomy is 5.5%. Active COVID-19 infection during surgery is strongly associated with an increased risk of EPAC. COVID-19 should be considered in perioperative risk assessment of EPAC.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration<\/jats:title>\n                    <jats:p>This study was registered as a clinical trial (NCT06787573). Retrospectively registered.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Graphical abstract<\/jats:title>\n                  <\/jats:sec>","DOI":"10.1007\/s10151-025-03232-1","type":"journal-article","created":{"date-parts":[[2025,11,5]],"date-time":"2025-11-05T05:57:17Z","timestamp":1762322237000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["COVID-19-specific risk factor for early post-appendectomy complications (EPAC) in older patients: a retrospective study"],"prefix":"10.1007","volume":"29","clinical-trial-number":[{"clinical-trial-number":"nct06787573","registry":"10.18810\/clinical-trials-gov"}],"author":[{"given":"Tamer A. A. 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