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The impact of COVID-19 on emergency general surgery admissions and operative volumes: A single centre experience
R M O'Connell1, M A Khan1, M Amir1
1Department of Surgery, Mayo University Hospital, Ireland.
Insights
The COVID-19 pandemic significantly reduced emergency surgical admissions by 42.8% and procedures by 25.4% in Ireland. This study highlights the pandemic's impact on emergency general surgery utilization.
Area of Science:
- Medicine
- Surgery
- Public Health
Background:
- The COVID-19 pandemic has strained global healthcare systems.
- Routine surgical care was widely postponed in Ireland.
- The pandemic's effect on emergency surgical disease burden was unclear.
Purpose of the Study:
- To investigate the impact of COVID-19 on emergency surgical patient presentations.
- To analyze the number of patients requiring emergency general surgical procedures during the pandemic.
Main Methods:
- Retrospective analysis of patient data from March 1st to April 30th, 2020.
- Comparison with data from the same period in 2017-2019.
- Collection of demographic, illness, and outcome data.
Main Results:
- A 42.8% reduction in emergency surgical admissions was observed (151 vs. 788).
- Emergency procedures decreased by 25.4% (mean 0.87/day vs. 1.16/day).
- Median patient age remained similar.
Conclusions:
- The COVID-19 pandemic led to a significant decrease in emergency surgical admissions and procedures.
- Findings align with international patterns of reduced surgical activity during the pandemic.
Introduction:
The COVID-19 pandemic has placed a significant strain on healthcare resources and utilisation globally. The appearance of the disease in the Republic of Ireland resulted in a broad postponement of scheduled and routine surgical care. The influence of the novel coronavirus, and the associated imposition of public health measures such as school closures and social distancing, on the burden of emergency surgical disease is less clear.
Aim:
The aim of this study was to examine the impact of COVID-19 on the number of patients presenting to our institution with emergent surgical illnesses or requiring emergency general surgical procedures.
Methods:
All patients attending our service between March 1st 2020 and April 30th 2020 were identified retrospectively by examining electronic handover and electronic discharge summaries, and data were collected relating to demographics, presenting illness, critical care utilisation, length of stay, operative or endoscopic procedure performed, and in-hospital mortality. Similar data were collected March 1st to April 30th 2019, 2018, and 2017 respectively to allow direct comparison.
Results:
151 patients were admitted during the study period, compared to a total of 788 during the proceeding three years (mean 2.49 admissions per night versus 4.35 per night, 42.8% reduction, p < 0.001). Median age of admitted patients was 51.8 years, compared to 50.3 years formerly (p = 0.35). 53 emergency procedures were performed, compared to a median of 70 over the same period in the previous years (mean 0.87 per day versus 1.16 per day, 25.4% reduction, p = 0.05).
Conclusion:
A significant overall reduction in the number of patients being admitted to our unit and requiring emergency surgical procedures during March and April 2020 was seen, in line with patterns reported internationally.
