The impact of the COVID-19 pandemic on emergency general surgery
a retrospective study
Keywords:
COVID-19 [supplementary concept], Pandemics, Surgery [subheading]Abstract
BACKGROUND: The COVID-19 pandemic has affected healthcare systems worldwide. The effect of the pandemic on emergency general surgery patients remains unknown. OBJECTIVE: To reveal the effects of the COVID-19 pandemic on mortality and morbidity among emergency general surgery cases. DESIGN AND SETTING: Data on patients who were admitted to the emergency department of a tertiary hospital in Samsun, Turkey, and had consultations at the general surgery clinic were analyzed retrospectively. METHODS: Our study included comparative analysis on two groups of patients who received emergency general surgery consultations in our hospital: during the COVID-19 pandemic period (Group 2); and on the same dates one year previously (Group 1). RESULTS: There were 195 patients in Group 1 and 132 in Group 2 (P < 0.001). While 113 (58%) of the patients in Group 1 were women, only 58 (44%) were women in Group 2 (P = 0.013). Considering all types of diagnosis, there was no significant difference between the two groups (P = 0.261). The rates of abscess and delayed abdominal emergency diseases were higher in Group 2: one case (0.5%) versus ten cases (8%); P < 0.001. The morbidity rate was higher in Group 2 than in Group 1: three cases (1.5%) versus nine cases (7%); P = 0.016. CONCLUSIONS: The COVID-19 pandemic has decreased the number of unnecessary nonemergency admissions to the emergency department, but has not delayed patients’ urgent consultations. The pandemic has led surgeons to deal with more complicated cases and greater numbers of complications.
Downloads
References
World Health Organization (WHO). Naming the coronavirus disease (COVID-19) and the virus that causes it. 2020. Available from: https://www.who.int/emergencies/diseases/novel-coronavirus-2019/technical-guidance/naming-the-coronavirusdisease-(covid-2019)-and-the-virus-that-causes-it. Accessed in 2020 (Sep 18).
Di Saverio S, Pata F, Gallo G, et al. Coronavirus pandemic and colorectal surgery: practical advice based on the Italian experience. Colorectal Dis. 2020;22(6):625-34. PMID: 32233064; https://doi.org/10.1111/codi.15056.
De Simone B, Chouillard E, Di Saverio S, et al. Emergency surgery during the COVID-19 pandemic: what you need to know for practice. Ann R Coll Surg Engl. 2020;102(5):323-32. PMID: 32352836; https://doi.org/10.1308/rcsann.2020.0097.
Coimbra R, Edwards S, Kurihara H, et al. European Society of Trauma and Emergency Surgery (ESTES) recommendations for trauma and emergency surgery preparation during times of COVID-19 infection. Eur J Trauma Emerg Surg. 2020;46(3):505-10. PMID: 32303798; https://doi.org/10.1016/j.surg.2020.03.012.
Guerci C, Maffioli A, Bondurri AA, Ferrario L, Lazzarin F, Danelli P. COVID-19: How can a department of general surgery survive in a pandemic? Surgery. 2020;167(6):909-11. PMID: 32299626; https://doi.org/10.1016/j.surg.2020.03.012.
Al-Balas M, Al-Balas HI, Al-Balas H. Surgery during the COVID-19 pandemic: A comprehensive overview and perioperative care. Am J Surg. 2020;219(6):903-06. PMID: 32334800; https://doi.org/10.1016/j.amjsurg.2020.04.018.
Coccolini F, Perrone G, Chiarugi M, et al. Surgery in COVID-19 patients: operational directives. World J Emerg Surg. 2020;15(1):25. PMID: 32264898; https://doi.org/10.1186/s13017-020-00307-2.
Hussain A, Mahawar K, El-Hasani S. The Impact of COVID-19 Pandemic on Obesity and Bariatric Surgery. Obes Surg. 2020;30(8):3222-3. PMID: 32388706; https://doi.org/10.1007/s11695-020-04637-7.
Lima DS, Ribeiro MAF Jr, Gallo G, Di Saverio S. Role of chest CT in patients with acute abdomen during the COVID-19 era. Br J Surg. 2020;107(7):e196. PMID: 32386064; https://doi.org/10.1002/bjs.11664.
Di Saverio S, Khan M, Pata F, et al. Laparoscopy at all costs? Not now during COVID-19 outbreak and not for acute care surgery and emergency colorectal surgery: A practical algorithm from a hub tertiary teaching hospital in Northern Lombardy, Italy. J Trauma Acute Care Surg. 2020;88(6):715-18. PMID: 32282750; https://doi.org/10.1097/TA.0000000000002727.
Pata F, Khan M, Iovino D, Di Saverio S. Laparotomy represents the safest option during COVID-19 outbreak online ahead of print. PMID: 32427770; https://doi.org/10.1097/TA.0000000000002791.
Di Saverio S, Pata F, Khan M, Ietto G, Zani E, Carcano G. Convert to open: the new paradigm for surgery during COVID-19? Br J Surg. 2020;107(7):e194. PMID: 32367551; https://doi.org/10.1002/bjs.11662.
Havens JM, Neiman PU, Campbell BL, et al. The Future of Emergency General Surgery. Ann Surg. 2019;270(2):221-2. PMID: 30614879; https://doi.org/10.1097/SLA.0000000000003183.
