The impact of COVID-19 pandemic on access to medical services and its consequences on emergency surgery
BackgroundOn March 9, 2020, the Italian Prime Minister announced the lockdown, which was officially closed on May 4. This extraordinary measure was necessary to contain the COVID-19 pandemic spread in Italy. During this phase, a significant decrease in patients' access to Emergency Department (...
| Main Authors: | , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2023-04-01
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| Series: | Frontiers in Surgery |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fsurg.2023.1059517/full |
| _version_ | 1797839036140748800 |
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| author | Giovanni Pirozzolo Bao Riccardo Quoc Chiara Vignotto Livio Baiano Alfredo Piangerelli Claudia Peluso Rubina Palumbo Fabrizio Giuseppe Maria Cimino Guido Meneghetti Alberto Grassetto Maurizio Rizzo Gabriele Giuseppe Maria Viola Francesco Fiumara Marco Scarpa Alfonso Giovanni Recordare Alfonso Giovanni Recordare |
| author_facet | Giovanni Pirozzolo Bao Riccardo Quoc Chiara Vignotto Livio Baiano Alfredo Piangerelli Claudia Peluso Rubina Palumbo Fabrizio Giuseppe Maria Cimino Guido Meneghetti Alberto Grassetto Maurizio Rizzo Gabriele Giuseppe Maria Viola Francesco Fiumara Marco Scarpa Alfonso Giovanni Recordare Alfonso Giovanni Recordare |
| author_sort | Giovanni Pirozzolo |
| collection | DOAJ |
| description | BackgroundOn March 9, 2020, the Italian Prime Minister announced the lockdown, which was officially closed on May 4. This extraordinary measure was necessary to contain the COVID-19 pandemic spread in Italy. During this phase, a significant decrease in patients' access to Emergency Department (ED) was observed. Delayed access to treatment determined a delay in the diagnosis of acute surgical conditions, as already documented in other clinical areas, with consequences on surgical outcome and survival. Aim of this study is to provide a detailed description of abdominal urgent-emergent conditions surgically treated and surgical outcomes during the lockdown in a tertiary referral Italian hospital, compared with historical data.MethodsA retrospective review of urgent-emergent patients surgically treated in our department was conducted in order to compare patients' characteristics and surgical outcomes during the period March 9th—May 4th, 2020 with the same period of the previous year.Results152 patients were included in our study, 79 patients in 2020 group and 77 patients in 2019. We found no significant differences between the groups regarding ASA score, age, gender, and disease prevalence. Significant differences were found in symptom duration before ER access and abdominal pain as the main symptom in non-traumatic conditions. We also performed a sub-analysis on peritonitis which showed significant differences in: hospital length of stay, presence of colostomy vs. ileostomy, and fatal events in 2020. No differences were found in the use of laparoscopy.ConclusionsWhile the overall number of ER accesses has decreased in 2020 group, the number of patients surgically treated in emergency-urgency conditions has not decreased. However, those patients waited significantly more before the hospital access. This diagnostic delay was associated with a more severe clinical condition and a consequent significantly worse prognosis. |
| first_indexed | 2024-04-09T15:50:35Z |
| format | Article |
| id | doaj.art-321f8c5101984c77be5f9998be64e084 |
| institution | Directory Open Access Journal |
| issn | 2296-875X |
| language | English |
| last_indexed | 2024-04-09T15:50:35Z |
| publishDate | 2023-04-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Surgery |
| spelling | doaj.art-321f8c5101984c77be5f9998be64e0842023-04-26T06:30:51ZengFrontiers Media S.A.Frontiers in Surgery2296-875X2023-04-011010.3389/fsurg.2023.10595171059517The impact of COVID-19 pandemic on access to medical services and its consequences on emergency surgeryGiovanni Pirozzolo0Bao Riccardo Quoc1Chiara Vignotto2Livio Baiano3Alfredo Piangerelli4Claudia Peluso5Rubina Palumbo6Fabrizio Giuseppe Maria Cimino7Guido Meneghetti8Alberto Grassetto9Maurizio Rizzo10Gabriele Giuseppe Maria Viola11Francesco Fiumara12Marco Scarpa13Alfonso Giovanni Recordare14Alfonso Giovanni Recordare15General and Emergency Surgery Unit, Dell’Angelo Hospital, AULSS3 Serenissima, Venice, ItalyClinica Chirurgica I, Department of Surgical, Oncological, and Gastroenterological Sciences, University of Padova, Padova, ItalyClinica Chirurgica I, Department of Surgical, Oncological, and Gastroenterological Sciences, University of Padova, Padova, ItalyGeneral and Emergency Surgery Unit, Dell’Angelo Hospital, AULSS3 Serenissima, Venice, ItalyDepartment of Surgical, Oncological, and Gastroenterological Sciences, University of Padova, Padova, ItalyDepartment of Surgical, Oncological, and Gastroenterological Sciences, University of Padova, Padova, ItalyGeneral and Emergency Surgery Unit, Dell’Angelo Hospital, AULSS3 Serenissima, Venice, ItalyGeneral and Emergency Surgery Unit, Dell’Angelo Hospital, AULSS3 Serenissima, Venice, ItalyGeneral and Emergency Surgery Unit, Dell’Angelo Hospital, AULSS3 Serenissima, Venice, ItalyAnesthesiology Department, Dell’Angelo Hospital, AULSS3 Serenissima, Venice, ItalyGeneral and Emergency Surgery Unit, Dell’Angelo Hospital, AULSS3 Serenissima, Venice, ItalyGeneral and Emergency Surgery Unit, Dell’Angelo Hospital, AULSS3 Serenissima, Venice, ItalyGeneral and Emergency Surgery Unit, Dell’Angelo Hospital, AULSS3 Serenissima, Venice, ItalyClinica Chirurgica I, Department of Surgical, Oncological, and Gastroenterological Sciences, University of Padova, Padova, ItalyGeneral and Emergency Surgery Unit, Dell’Angelo Hospital, AULSS3 Serenissima, Venice, ItalyTbilisi State Medical University (TSMU), Tbilisi, GeorgiaBackgroundOn March 9, 2020, the Italian Prime Minister announced the lockdown, which was officially closed on May 4. This extraordinary measure was necessary to contain the COVID-19 pandemic spread in Italy. During this phase, a significant decrease in patients' access to Emergency Department (ED) was observed. Delayed access to treatment determined a delay in the diagnosis of acute surgical conditions, as already documented in other clinical areas, with consequences on surgical outcome and survival. Aim of this study is to provide a detailed description of abdominal urgent-emergent conditions surgically treated and surgical outcomes during the lockdown in a tertiary referral Italian hospital, compared with historical data.MethodsA retrospective review of urgent-emergent patients surgically treated in our department was conducted in order to compare patients' characteristics and surgical outcomes during the period March 9th—May 4th, 2020 with the same period of the previous year.Results152 patients were included in our study, 79 patients in 2020 group and 77 patients in 2019. We found no significant differences between the groups regarding ASA score, age, gender, and disease prevalence. Significant differences were found in symptom duration before ER access and abdominal pain as the main symptom in non-traumatic conditions. We also performed a sub-analysis on peritonitis which showed significant differences in: hospital length of stay, presence of colostomy vs. ileostomy, and fatal events in 2020. No differences were found in the use of laparoscopy.ConclusionsWhile the overall number of ER accesses has decreased in 2020 group, the number of patients surgically treated in emergency-urgency conditions has not decreased. However, those patients waited significantly more before the hospital access. This diagnostic delay was associated with a more severe clinical condition and a consequent significantly worse prognosis.https://www.frontiersin.org/articles/10.3389/fsurg.2023.1059517/fullemergency surgeryperitonitissurgical outcomecomplicationssurvivalCOVID-19 |
| spellingShingle | Giovanni Pirozzolo Bao Riccardo Quoc Chiara Vignotto Livio Baiano Alfredo Piangerelli Claudia Peluso Rubina Palumbo Fabrizio Giuseppe Maria Cimino Guido Meneghetti Alberto Grassetto Maurizio Rizzo Gabriele Giuseppe Maria Viola Francesco Fiumara Marco Scarpa Alfonso Giovanni Recordare Alfonso Giovanni Recordare The impact of COVID-19 pandemic on access to medical services and its consequences on emergency surgery Frontiers in Surgery emergency surgery peritonitis surgical outcome complications survival COVID-19 |
| title | The impact of COVID-19 pandemic on access to medical services and its consequences on emergency surgery |
| title_full | The impact of COVID-19 pandemic on access to medical services and its consequences on emergency surgery |
| title_fullStr | The impact of COVID-19 pandemic on access to medical services and its consequences on emergency surgery |
| title_full_unstemmed | The impact of COVID-19 pandemic on access to medical services and its consequences on emergency surgery |
| title_short | The impact of COVID-19 pandemic on access to medical services and its consequences on emergency surgery |
| title_sort | impact of covid 19 pandemic on access to medical services and its consequences on emergency surgery |
| topic | emergency surgery peritonitis surgical outcome complications survival COVID-19 |
| url | https://www.frontiersin.org/articles/10.3389/fsurg.2023.1059517/full |
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