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Factors affecting 30-day postoperative complications after emergency surgery during the COVID-19 outbreak: A

Ellen de Bock1, Mando D Filipe1, Apollo Pronk2

  • 1Department of Surgery, Cancer Centre, University Medical Centre Utrecht, the Netherlands.

International Journal of Surgery Open
|September 27, 2021
PubMed

Insights

Emergency surgery trends shifted during COVID-19, with increased vascular and trauma procedures. Advanced age, American Society of Anaesthesiologists (ASA) score, and surgical specialty independently predicted postoperative complications.

Area of Science:

  • Surgical care and public health
  • Epidemiology of surgical outcomes

Background:

  • The COVID-19 pandemic significantly impacted global surgical care delivery.
  • Measures to maintain healthcare capacity influenced surgical prioritization.
  • Limited data exists on the specific effects on emergency surgery during the pandemic's initial phase.

Purpose of the Study:

  • To analyze trends in emergency surgical procedures during the first wave of the COVID-19 pandemic.
  • To identify factors associated with increased risk of postoperative complications in emergency surgery patients.

Main Methods:

  • A multicentre retrospective cohort study included 1399 emergency surgery patients operated on between March 9th and June 30th, 2020.
  • Primary endpoint: number of emergency surgical procedures performed.
  • Secondary endpoints: postoperative complication rates and predictive factors analyzed using multivariate analysis (Odds Ratio, 95% Confidence Intervals).

Main Results:

  • Emergency vascular and trauma surgical procedures increased during the study period.
  • Emergency general and oncological surgical procedures remained stable.
  • Increased age (OR 1.01), American Society of Anaesthesiologists (ASA) score (OR 1.34), and surgical discipline were independent predictors of postoperative complications.

Conclusions:

  • Emergency vascular and trauma surgery volumes rose during the initial COVID-19 wave.
  • Emergency general and oncological surgery volumes were maintained.
  • Patient age, ASA score, and surgical specialty are key factors influencing postoperative complication risk in emergency surgery.
Abstract

Keywords:
COVID-19Emergency surgeryPandemicsPostoperative complicationsSARS-CoV-2

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