Proctologic emergency consultation during COVID-19: Comparative cross-sectional cohort study

Area of Science:

• Colorectal Surgery
• Emergency Medicine
• Infectious Disease Epidemiology

Background:

• Proctologic issues are a common reason for emergency department (ED) visits.
• The SARS-CoV-2 pandemic significantly altered healthcare-seeking behaviors and resource allocation.

Purpose of the Study:

• To analyze the impact of the SARS-CoV-2 pandemic on the demand for proctologic consultations in the ED.
• To compare proctologic consultation trends before and during the pandemic.

Main Methods:

• A retrospective, descriptive, comparative study of patients with proctologic complaints in the ED.
• Data collected from March-April 2019 and March-April 2020, analyzing demographics, diagnoses, and treatments.
• Four pandemic-related periods were assessed to understand evolving limitations.

Main Results:

• A 56% reduction in daily proctologic consultations was observed in 2020 compared to 2019 (0.95 vs. 2.18 patients/day).
• The rate of perianal abscesses doubled in 2020 (22.4% vs. 11.3%), and the need for surgery increased significantly (31% vs. 15%).
• No significant difference in outpatient management post-emergency surgery or readmission rates was noted between the years.

Conclusions:

• The pandemic led to a substantial decrease in emergency proctologic consultations.
• Despite fewer consultations, the proportion requiring surgical intervention doubled, highlighting a potential shift towards more severe presentations.
• Further reflection on appropriate utilization of emergency services for proctologic conditions is warranted.