Emergency surgery admissions and the COVID-19 pandemic: did the first wave really change our practice? Results of an ACOI/WSES international retrospective cohort audit on 6263 patients
Abstract Introduction The COVID-19 pandemic is having a deep impact on emergency surgical services, with a significant reduction of patients admitted into emergency surgical units world widely. Reliable figures of this reduction have not been produced yet. Our international audit aimed at giving a p...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2022-01-01
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| Series: | World Journal of Emergency Surgery |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13017-022-00407-1 |
| _version_ | 1819281438704402432 |
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| author | Giovanni D. Tebala Marika S. Milani Mark Bignell Giles Bond-Smith Christopher Lewis Roberto Cirocchi Salomone Di Saverio Fausto Catena Marco Scatizzi Pierluigi Marini the CovidICE-International Collaborative |
| author_facet | Giovanni D. Tebala Marika S. Milani Mark Bignell Giles Bond-Smith Christopher Lewis Roberto Cirocchi Salomone Di Saverio Fausto Catena Marco Scatizzi Pierluigi Marini the CovidICE-International Collaborative |
| author_sort | Giovanni D. Tebala |
| collection | DOAJ |
| description | Abstract Introduction The COVID-19 pandemic is having a deep impact on emergency surgical services, with a significant reduction of patients admitted into emergency surgical units world widely. Reliable figures of this reduction have not been produced yet. Our international audit aimed at giving a precise snapshot of the absolute and relative changes of emergency surgical admissions at the outbreak of the pandemic. Materials and methods Datasets of patients admitted as general surgical emergencies into 45 internationally distributed emergency surgical units during the months of March and April 2020 (Covid-19 pandemic outbreak) were collected and compared with those of patients admitted into the same units during the months of March and April 2019 (pre-Covid-19). Primary endpoint was to evaluate the relative variation of the presentation symptoms and discharge diagnoses between the two study periods. Secondary endpoint was to identify the possible change of therapeutic strategy during the same two periods. Results Forty-five centres participated sent their anonymised data to the study hub, for a total of 6263 patients. Of these, 3810 were admitted in the pre-Covid period and 2453 in the Covid period, for a 35.6% absolute reduction. The most common presentation was abdominal pain, whose incidence did not change between the two periods, but in the Covid period patients presented less frequently with anal pain, hernias, anaemia and weight loss. ASA 1 and low frailty patients were admitted less frequently, while ASA>1 and frail patients showed a relative increase. The type of surgical access did not change significantly, but lap-to-open conversion rate halved between the two study periods. Discharge diagnoses of appendicitis and diverticulitis reduced significantly, while bowel ischaemia and perianal ailments had a significant relative increase. Conclusions Our audit demonstrates a significant overall reduction of emergency surgery admissions at the outbreak of the Covid-19 pandemic with a minimal change of the proportions of single presentations, diagnoses and treatments. These findings may open the door to new ways of managing surgical emergencies without engulfing the already busy hospitals. |
| first_indexed | 2024-12-24T00:59:42Z |
| format | Article |
| id | doaj.art-2b9fd06b0afe482cb3823a6ba921d826 |
| institution | Directory Open Access Journal |
| issn | 1749-7922 |
| language | English |
| last_indexed | 2024-12-24T00:59:42Z |
| publishDate | 2022-01-01 |
| publisher | BMC |
| record_format | Article |
| series | World Journal of Emergency Surgery |
| spelling | doaj.art-2b9fd06b0afe482cb3823a6ba921d8262022-12-21T17:23:24ZengBMCWorld Journal of Emergency Surgery1749-79222022-01-0117111110.1186/s13017-022-00407-1Emergency surgery admissions and the COVID-19 pandemic: did the first wave really change our practice? Results of an ACOI/WSES international retrospective cohort audit on 6263 patientsGiovanni D. Tebala0Marika S. Milani1Mark Bignell2Giles Bond-Smith3Christopher Lewis4Roberto Cirocchi5Salomone Di Saverio6Fausto Catena7Marco Scatizzi8Pierluigi Marini9the CovidICE-International CollaborativeSurgical Emergency Unit, Oxford University Hospitals NHS Foundation TrustDepartment of General Surgery, Causa Pia Luvini HospitalSurgical Emergency Unit, Oxford University Hospitals NHS Foundation TrustSurgical Emergency Unit, Oxford University Hospitals NHS Foundation TrustSurgical Emergency Unit, Oxford University Hospitals NHS Foundation TrustDepartment of General Surgery, University of PerugiaDepartment of General Surgery, Madonna del Soccorso HospitalDepartment of General and Emergency Surgery, “M. Bufalini” HospitalDepartment of General Surgery, S. Maria Annunziata HospitalDepartment of General and Emergency Surgery, S. Camillo-Forlanini HospitalAbstract Introduction The COVID-19 pandemic is having a deep impact on emergency surgical services, with a significant reduction of patients admitted into emergency surgical units world widely. Reliable figures of this reduction have not been produced yet. Our international audit aimed at giving a precise snapshot of the absolute and relative changes of emergency surgical admissions at the outbreak of the pandemic. Materials and methods Datasets of patients admitted as general surgical emergencies into 45 internationally distributed emergency surgical units during the months of March and April 2020 (Covid-19 pandemic outbreak) were collected and compared with those of patients admitted into the same units during the months of March and April 2019 (pre-Covid-19). Primary endpoint was to evaluate the relative variation of the presentation symptoms and discharge diagnoses between the two study periods. Secondary endpoint was to identify the possible change of therapeutic strategy during the same two periods. Results Forty-five centres participated sent their anonymised data to the study hub, for a total of 6263 patients. Of these, 3810 were admitted in the pre-Covid period and 2453 in the Covid period, for a 35.6% absolute reduction. The most common presentation was abdominal pain, whose incidence did not change between the two periods, but in the Covid period patients presented less frequently with anal pain, hernias, anaemia and weight loss. ASA 1 and low frailty patients were admitted less frequently, while ASA>1 and frail patients showed a relative increase. The type of surgical access did not change significantly, but lap-to-open conversion rate halved between the two study periods. Discharge diagnoses of appendicitis and diverticulitis reduced significantly, while bowel ischaemia and perianal ailments had a significant relative increase. Conclusions Our audit demonstrates a significant overall reduction of emergency surgery admissions at the outbreak of the Covid-19 pandemic with a minimal change of the proportions of single presentations, diagnoses and treatments. These findings may open the door to new ways of managing surgical emergencies without engulfing the already busy hospitals.https://doi.org/10.1186/s13017-022-00407-1Emergency surgeryCovid-19Admission |
| spellingShingle | Giovanni D. Tebala Marika S. Milani Mark Bignell Giles Bond-Smith Christopher Lewis Roberto Cirocchi Salomone Di Saverio Fausto Catena Marco Scatizzi Pierluigi Marini the CovidICE-International Collaborative Emergency surgery admissions and the COVID-19 pandemic: did the first wave really change our practice? Results of an ACOI/WSES international retrospective cohort audit on 6263 patients World Journal of Emergency Surgery Emergency surgery Covid-19 Admission |
| title | Emergency surgery admissions and the COVID-19 pandemic: did the first wave really change our practice? Results of an ACOI/WSES international retrospective cohort audit on 6263 patients |
| title_full | Emergency surgery admissions and the COVID-19 pandemic: did the first wave really change our practice? Results of an ACOI/WSES international retrospective cohort audit on 6263 patients |
| title_fullStr | Emergency surgery admissions and the COVID-19 pandemic: did the first wave really change our practice? Results of an ACOI/WSES international retrospective cohort audit on 6263 patients |
| title_full_unstemmed | Emergency surgery admissions and the COVID-19 pandemic: did the first wave really change our practice? Results of an ACOI/WSES international retrospective cohort audit on 6263 patients |
| title_short | Emergency surgery admissions and the COVID-19 pandemic: did the first wave really change our practice? Results of an ACOI/WSES international retrospective cohort audit on 6263 patients |
| title_sort | emergency surgery admissions and the covid 19 pandemic did the first wave really change our practice results of an acoi wses international retrospective cohort audit on 6263 patients |
| topic | Emergency surgery Covid-19 Admission |
| url | https://doi.org/10.1186/s13017-022-00407-1 |
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