{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T22:39:00Z","timestamp":1740177540879,"version":"3.37.3"},"reference-count":24,"publisher":"BMJ","issue":"1","license":[{"start":{"date-parts":[[2022,12,9]],"date-time":"2022-12-09T00:00:00Z","timestamp":1670544000000},"content-version":"unspecified","delay-in-days":8,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Trauma Surg Acute Care Open"],"accepted":{"date-parts":[[2022,11,24]]},"published-print":{"date-parts":[[2022,12]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>The COVID-19 pandemic highlighted concerns regarding the equity of medical care. We evaluated associations between race\/ethnicity, timing of hospital presentation and outcomes of acute appendicitis (AP) and acute cholecystitis (AC) during the initial pandemic peak.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Analysis was performed on a prospective, observational, multicenter study of adults with AP or AC. Patients were categorized as pre-pandemic (pre-CoV: October 2019\u2013January 2020) or during the first pandemic peak (CoV: April 2020 through 4 months following the end of local pandemic restrictions). Patient demographics, American Association for the Surgery of Trauma (AAST) imaging\/pathology grade, duration of symptoms before triage, time from triage to intervention and hospital length of stay were collected.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 2165 patients (1496 pre-CoV, 669 CoV) were included from 19 centers. Asian and Hispanic patients with AC had a longer duration of symptoms prior to presentation during CoV than pre-CoV (100.6 hours vs 37.5 hours, p&lt;0.01 and 85.7 hours vs 52.5 hours, p&lt;0.05, respectively) and presented later during CoV than Black or White patients (34.3 and 37.9 hours, p&lt;0.01). During CoV, Asian patients presented with higher AAST pathology grade for AP compared with pre-CoV (1.90 vs 1.26, p&lt;0.01). Asian and Hispanic patients presented with higher AAST pathology grade for AC during CoV versus pre-CoV (2.57 vs 1.45, p&lt;0.01, and 1.57 vs 1.20, p&lt;0.05, respectively). Patients with AC and an AAST pathology grade of \u22653 were at higher odds of postoperative complications (OR 4.4, 95% CI 1.0 to 18.4) and AP (OR 2.8, 95% CI 1.3 to 6.0). Asian and Hispanic patients with AC had a higher risk of postoperative complications compared to White patients (Asian: OR 3.9, 95% CI 1.2 to 12.7; Hispanic: OR 3.3, 95% CI 1.2 to 8.9).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Asian and Hispanic patients had a longer duration of symptoms before hospital presentation during the initial COVID-19 peak, had higher odds of postoperative complications and more advanced pathologic disease.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of evidence<\/jats:title><jats:p>III, Prognostic\/epidemiological.<\/jats:p><\/jats:sec>","DOI":"10.1136\/tsaco-2022-001023","type":"journal-article","created":{"date-parts":[[2022,12,9]],"date-time":"2022-12-09T14:17:09Z","timestamp":1670595429000},"page":"e001023","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Racial and ethnic variation in emergent surgical care and outcomes during the COVID-19 pandemic: post hoc analysis of an EAST MCT"],"prefix":"10.1136","volume":"7","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0784-2679","authenticated-orcid":false,"given":"Nolan M","family":"Winicki","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alden","family":"Dahan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Somiya","family":"Maheshwari","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brandon","family":"Crowley","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rondi","family":"Gelbard","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sigrid","family":"Burruss","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2022,12,9]]},"reference":[{"key":"2024051312124737000_7.1.e001023.1","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/jiaa372"},{"key":"2024051312124737000_7.1.e001023.2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMsa2011686"},{"key":"2024051312124737000_7.1.e001023.3","doi-asserted-by":"crossref","first-page":"946","DOI":"10.1007\/s00268-021-05958-z","article-title":"Impact of COVID-19 restrictions on demographics and outcomes of patients undergoing medically necessary Non-Emergent surgeries during the pandemic","volume":"45","author":"Shannon","year":"2021","journal-title":"World J Surg"},{"key":"2024051312124737000_7.1.e001023.4","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm6923e1"},{"key":"2024051312124737000_7.1.e001023.5","doi-asserted-by":"publisher","DOI":"10.1007\/s00268-020-05599-8"},{"key":"2024051312124737000_7.1.e001023.6","doi-asserted-by":"crossref","first-page":"1610","DOI":"10.1016\/j.jaccas.2020.05.045","article-title":"Complication of late presenting STEMI due to avoidance of medical care during the COVID-19 pandemic","volume":"2","author":"Otero","year":"2020","journal-title":"JACC Case Rep"},{"key":"2024051312124737000_7.1.e001023.7","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.120.030105"},{"key":"2024051312124737000_7.1.e001023.8","unstructured":"Trauma AAftSo . 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