Impact of the COVID-19 pandemic on delays in surgical procedures in Germany: a multi-center analysis of an administrative registry of 176,783 patients
Abstract Background While extensive data are available on the postponement of elective surgical procedures due to the COVID-19 pandemic for Germany, data on the impact on emergency procedures is limited. Methods In this retrospective case–control study, anonymized case-related routine data of a Germ...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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BMC
2022-06-01
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| Series: | Patient Safety in Surgery |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13037-022-00331-y |
| _version_ | 1818488352856342528 |
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| author | Richard Hunger Volker König Rosi Stillger René Mantke |
| author_facet | Richard Hunger Volker König Rosi Stillger René Mantke |
| author_sort | Richard Hunger |
| collection | DOAJ |
| description | Abstract Background While extensive data are available on the postponement of elective surgical procedures due to the COVID-19 pandemic for Germany, data on the impact on emergency procedures is limited. Methods In this retrospective case–control study, anonymized case-related routine data of a Germany-wide voluntary hospital association (CLINOTEL association) of 66 hospitals was analyzed. Operation volumes, in-hospital mortality, and COVID-19 prevalence rates in digestive surgery procedure groups and selected single surgical procedures in the one-year periods before and after the outbreak of the COVID-19 pandemic were analyzed. The analysis was stratified by admitting department (direct admission or transfer to the general surgical department, i.e., primary or secondary surgical patients) and type of admission (elective/emergent). Results The total number of primary and secondary surgical patients decreased by 22.7% and 11.7%, respectively. Among primary surgical patients more pronounced reductions were observed in elective (-25.6%) than emergency cases (-18.8%). Most affected procedures were thyroidectomies (-30.2%), operations on the anus (-24.2%), and closure of abdominal hernias (-23.9%; all P’s < 0.001). Declines were also observed in colorectal (-9.0%, P = 0.002), but not in rectal cancer surgery (-3.9%, n.s.). Mortality was slightly increased in primary (1.3 vs. 1.5%, P < 0.001), but not in secondary surgical cases. The one-year prevalence of COVID-19 in general surgical patients was low (0.6%), but a significant driver of mortality (OR = 9.63, P < 0.001). Conclusions Compared to the previous year period, the number of patients in general and visceral surgery decreased by 22.7% in the first pandemic year. At the procedure level, a decrease of 14.8% was observed for elective procedures and 6.0% for emergency procedures. COVID-19 infections in general surgical patients are rare (0.6% prevalence), but associated with high mortality (21.8%). Trial registration The present study does not meet the ICMJE definition of a clinical trial and was therefore not registered. |
| first_indexed | 2024-12-10T16:50:00Z |
| format | Article |
| id | doaj.art-0bc289688804487798b5f7a233aa128b |
| institution | Directory Open Access Journal |
| issn | 1754-9493 |
| language | English |
| last_indexed | 2024-12-10T16:50:00Z |
| publishDate | 2022-06-01 |
| publisher | BMC |
| record_format | Article |
| series | Patient Safety in Surgery |
| spelling | doaj.art-0bc289688804487798b5f7a233aa128b2022-12-22T01:40:55ZengBMCPatient Safety in Surgery1754-94932022-06-0116111110.1186/s13037-022-00331-yImpact of the COVID-19 pandemic on delays in surgical procedures in Germany: a multi-center analysis of an administrative registry of 176,783 patientsRichard Hunger0Volker König1Rosi Stillger2René Mantke3Department of General Surgery, University Hospital Brandenburg, Brandenburg Medical School Theodor FontaneCLINOTEL Hospital Association gGmbHCLINOTEL Hospital Association gGmbHDepartment of General Surgery, University Hospital Brandenburg, Brandenburg Medical School Theodor FontaneAbstract Background While extensive data are available on the postponement of elective surgical procedures due to the COVID-19 pandemic for Germany, data on the impact on emergency procedures is limited. Methods In this retrospective case–control study, anonymized case-related routine data of a Germany-wide voluntary hospital association (CLINOTEL association) of 66 hospitals was analyzed. Operation volumes, in-hospital mortality, and COVID-19 prevalence rates in digestive surgery procedure groups and selected single surgical procedures in the one-year periods before and after the outbreak of the COVID-19 pandemic were analyzed. The analysis was stratified by admitting department (direct admission or transfer to the general surgical department, i.e., primary or secondary surgical patients) and type of admission (elective/emergent). Results The total number of primary and secondary surgical patients decreased by 22.7% and 11.7%, respectively. Among primary surgical patients more pronounced reductions were observed in elective (-25.6%) than emergency cases (-18.8%). Most affected procedures were thyroidectomies (-30.2%), operations on the anus (-24.2%), and closure of abdominal hernias (-23.9%; all P’s < 0.001). Declines were also observed in colorectal (-9.0%, P = 0.002), but not in rectal cancer surgery (-3.9%, n.s.). Mortality was slightly increased in primary (1.3 vs. 1.5%, P < 0.001), but not in secondary surgical cases. The one-year prevalence of COVID-19 in general surgical patients was low (0.6%), but a significant driver of mortality (OR = 9.63, P < 0.001). Conclusions Compared to the previous year period, the number of patients in general and visceral surgery decreased by 22.7% in the first pandemic year. At the procedure level, a decrease of 14.8% was observed for elective procedures and 6.0% for emergency procedures. COVID-19 infections in general surgical patients are rare (0.6% prevalence), but associated with high mortality (21.8%). Trial registration The present study does not meet the ICMJE definition of a clinical trial and was therefore not registered.https://doi.org/10.1186/s13037-022-00331-yCOVID-19Elective surgeryEmergent surgeryGeneral surgeryHealth care research |
| spellingShingle | Richard Hunger Volker König Rosi Stillger René Mantke Impact of the COVID-19 pandemic on delays in surgical procedures in Germany: a multi-center analysis of an administrative registry of 176,783 patients Patient Safety in Surgery COVID-19 Elective surgery Emergent surgery General surgery Health care research |
| title | Impact of the COVID-19 pandemic on delays in surgical procedures in Germany: a multi-center analysis of an administrative registry of 176,783 patients |
| title_full | Impact of the COVID-19 pandemic on delays in surgical procedures in Germany: a multi-center analysis of an administrative registry of 176,783 patients |
| title_fullStr | Impact of the COVID-19 pandemic on delays in surgical procedures in Germany: a multi-center analysis of an administrative registry of 176,783 patients |
| title_full_unstemmed | Impact of the COVID-19 pandemic on delays in surgical procedures in Germany: a multi-center analysis of an administrative registry of 176,783 patients |
| title_short | Impact of the COVID-19 pandemic on delays in surgical procedures in Germany: a multi-center analysis of an administrative registry of 176,783 patients |
| title_sort | impact of the covid 19 pandemic on delays in surgical procedures in germany a multi center analysis of an administrative registry of 176 783 patients |
| topic | COVID-19 Elective surgery Emergent surgery General surgery Health care research |
| url | https://doi.org/10.1186/s13037-022-00331-y |
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