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A Retrospective Study on the Impact of COVID-19 on Emergency General Surgery
Leo Kretzmer1, Ahmed Elmaradny2, Murad A Jabir3,1
1Department of General Surgery, Worcestershire Acute Hospitals NHS Trust, Worcester, GBR.
Insights
The COVID-19 pandemic disrupted emergency surgery, with initial declines in patient numbers and surgical procedures. However, healthcare practices gradually adapted, showing resilience and adjustment to the new normal during subsequent waves.
Area of Science:
- Medicine
- Surgery
- Public Health
Background:
- The coronavirus pandemic (COVID-19) caused unprecedented global disruption, significantly impacting healthcare systems and surgical practices.
- Societal, medical, and behavioral changes necessitated adaptations in emergency surgical care delivery.
- This study examines the effects of the COVID-19 pandemic on a major surgical center.
Purpose of the Study:
- To investigate the impact of the COVID-19 pandemic on emergency surgical practices.
- To analyze changes in patient referrals, diagnoses, investigations, management, and outcomes.
- To understand the adaptation of consultant surgical practice during the pandemic.
Main Methods:
- Retrospective observational study analyzing three periods: pre-COVID, first wave, and second wave.
- Data collected on patient pathways, clinical decisions, and consultant practices.
- Statistical analysis using ANOVA and Mann-Whitney U tests.
Main Results:
- Patient presentation numbers declined across all study periods.
- The first wave saw severe disruption to emergency general surgery due to altered decision-making and patient behavior.
- Despite increased hospitalization and mortality in the second wave, a gradual return to pre-pandemic norms in referral and management was observed.
Conclusions:
- Societal and medical spheres demonstrated adaptation to living with COVID-19.
- Emergency surgical services showed resilience and a capacity to adjust to pandemic-related challenges.
- The findings suggest a normalization of practices despite the ongoing pandemic.
Abstract:
Background The coronavirus pandemic has caused global disruption to all aspects of life. This disturbance has been most notable in the medical world. Political, societal, medical, and behavioral alterations have forced emergency surgical practices to adapt. This study investigated the impact of coronavirus 2019 (COVID-19) at a busy surgical center. Methodology This is a retrospective observational study. Three study periods were analyzed: pre-COVID, first wave, and second wave. Data were collected on referrals, diagnoses, investigations, management pathways, outcomes, patient behavior, and consultant practice. A one-way analysis of variance (ANOVA test) was used for the analysis of parametric data and the Mann-Whitney U test for non-parametric data. Results Declining numbers of patients presented across the three periods. There was a severe disruption in performing emergency general surgeries during the first wave, propagated by alterations in clinical decision-making, as well as fluctuations in societal and patient behavior. Despite the effects of the second wave being significantly more profound in terms of hospitalization and COVID-related mortality, a paradoxical, gradual return to the norm was noted, which was seen in referral pathways, imaging decisions, and management strategies. Conclusion Our data is suggestive of society, both within and outside the medical sphere, adjusting to life with COVID-19.
