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COVID-19 Pandemic Significantly Decreases Acute Surgical Complaints
John S Riley1, Valerie L Luks1, Luis Filipe de Pina1
121798 Department of Surgery, Hospital of the University of Pennsylvania, Philadelphia, PA, USA.
Insights
The COVID-19 pandemic decreased surgical consults by 43%, particularly for less acute cases. However, the rate of surgical intervention remained similar, with increased vascular access consultations noted.
Area of Science:
- Surgery
- Infectious Diseases
- Public Health
Background:
- The COVID-19 pandemic impacted elective surgeries nationwide.
- The effect on acute surgical conditions and acute care surgery remained unclear.
Purpose of the Study:
- To investigate the impact of the COVID-19 pandemic on acute surgical complaints.
- To analyze changes in surgical consult volume and intervention rates.
Main Methods:
- Retrospective review of surgical consults at a major academic hospital.
- Analysis of consults in the 30 days before and after the first COVID-19 case.
Main Results:
- Total surgical consult volume decreased by 43% post-COVID-19.
- A disproportionate reduction was observed in less acute surgical complaints.
- The rate of surgical intervention per consult remained consistent (31% vs. 28%).
- Vascular access consultations increased due to COVID-19 inpatient care.
Conclusions:
- The COVID-19 pandemic significantly reshaped the patterns of acute surgical complaints.
- Understanding these shifts is crucial for resource allocation in surgical departments during the pandemic.
Background:
The coronavirus disease 2019 (COVID-19) pandemic significantly reduced elective surgery in the United States, but the impact of COVID-19 on acute surgical complaints and acute care surgery is unknown.
Study Design:
A retrospective review was performed of all surgical consults at the Hospital of the University of Pennsylvania in the 30 days prior to and 30 days following confirmation of the first COVID-19 patient at the institution. Consults to all divisions within general surgery were included.
Results:
Total surgical consult volume decreased by 43% in the post-COVID-19 period, with a significant reduction in the median daily consult volume from 14 to 8 (P < .0001). Changes in consult volume by patient location, chief complaint, and surgical division were variable, in aggregate reflecting a disproportionate decrease among less acute surgical complaints. The percentage of consults resulting in surgical intervention remained equal in the 2 periods (31% vs 28%, odds ratio 0.85, 95% CI 0.61-1.21, P = .38) with most but not all operation types decreasing in frequency. The rise in the COVID-19 inpatient census led to increased consultation for vascular access, accommodated at our center by the creation of a new surgical procedures team.
Conclusion:
The COVID-19 pandemic significantly altered the landscape of acute surgical complaints at our large academic hospital. An appreciation of these trends may be helpful to other Departments of Surgery around the country as they deploy staff and allocate resources in the COVID-19 era.
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