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Dramatic decrease of surgical emergencies during COVID-19 outbreak.

Stefano Rausei1, Francesco Ferrara, Tommaso Zurleni

  • 1From the General Surgery Unit (S.R.), ASST Valle Olona, Gallarate, Varese; General Surgery Unit (F. Ferrara), San Carlo Borromeo Hospital, ASST Santi Paolo e Carlo, Milan; General Surgery Unit (T.Z.), ASST Valle Olona, Busto Arsizio; General Surgery Unit (F. Frattini), ASST Settelaghi, Tradate, Varese; General Surgery and Trauma Team (O.C.), ASST Niguarda, Milan; General Surgery Unit (A.P.), IRCCS Policlinico San Matteo, Pavia; and General Surgery Unit (G.S.), ASST Ovest Milanese, Magenta, Milan, Italy.

The Journal of Trauma and Acute Care Surgery
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Summary
This summary is machine-generated.

Emergency surgical admissions and procedures significantly decreased during the COVID-19 pandemic, with notable exceptions for gastrointestinal bleeding and abdominal trauma. This study confirms a dramatic drop in surgical emergencies.

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Area of Science:

  • Surgery
  • Epidemiology
  • Public Health

Background:

  • The coronavirus disease 2019 (COVID-19) pandemic led to a general reduction in surgical activity.
  • Limited data exist on the impact on emergency surgical care.
  • This study addresses the need for extensive data on emergency surgical admissions and procedures during the pandemic.

Purpose of the Study:

  • To analyze the real number of admissions and procedures for emergency surgical disease during the COVID-19 pandemic.
  • To quantify the impact of the COVID-19 outbreak on emergency general surgery services.

Main Methods:

  • Multicenter study involving 18 general surgery units in Lombardy's "Red Zone" hospitals.
  • Collected data on emergency department admissions and surgical procedures for March 2019 vs. March 2020.
  • Analyzed data based on surgical indications, comparing admission and procedure rates.

Main Results:

  • Emergency surgical admissions decreased by 45% (p < 0.001) and operations by 41% (p = 0.001).
  • Reductions were consistent across indications, except for gastrointestinal bleeding admissions/operations and abdominal trauma operations.
  • The ratio of surgical procedures to diagnosed diseases remained similar overall (54% vs. 63%; p = 0.619), with significant differences only in bowel obstruction and gastrointestinal perforation.

Conclusions:

  • The dramatic decrease in surgical problems during the COVID-19 outbreak is confirmed.
  • Findings hold true despite therapeutic strategies and logistical challenges.
  • The study provides crucial epidemiological data on emergency surgery during a pandemic.