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Increased Complications of Emergent Surgical Procedures During the First Wave of COVID-19

Christina Colosimo1, Bryce Ingram1, John Weaver1

  • 1Sky Ridge Medical Center, Lone Tree, Colorado.

The Journal of Surgical Research
|February 2, 2023
PubMed

Insights

Surgical volumes significantly decreased during the COVID-19 pandemic's first wave. Complication rates and mortality increased for all analyzed surgeries, with infection and SIRS/sepsis being significant for appendectomies.

Area of Science:

  • Surgical outcomes and patient safety
  • Epidemiology of surgical procedures
  • Impact of pandemics on healthcare

Background:

  • Elective surgeries were halted during the COVID-19 pandemic's initial wave, following CMS recommendations.
  • Despite open hospitals for emergent cases, studies indicated a reduction in overall surgical volume.

Purpose of the Study:

  • To analyze the impact of the COVID-19 pandemic's first wave on surgical volumes and patient outcomes.
  • To compare surgical data from March-May 2020 with the same period in 2019.

Main Methods:

  • Retrospective analysis of all surgeries across 185 hospitals.
  • Comparison of data from March-May 2019 (pre-pandemic) and March-May 2020 (first wave).
  • Focused analysis on appendectomies, cholecystectomies, craniotomies, exploratory laparotomies, and ERCPs.

Main Results:

  • Overall surgical volume decreased from 326,726 (2019) to 237,809 (2020).
  • Significant reductions observed in appendectomy, cholecystectomy, exploratory laparotomy, craniotomy, and ERCP volumes.
  • Increased rates of acute kidney injury, infection, SIRS, and sepsis were noted for the analyzed surgeries in 2020 compared to 2019.

Conclusions:

  • The first wave of the COVID-19 pandemic led to a significant decrease in surgical procedures.
  • An increase in mortality and complication rates was observed across five key surgical types.
  • Infection and SIRS/sepsis emerged as statistically significant complications for appendectomies during this period.
Abstract

Keywords:
AppendectomiesCOVID-19CholecystectomiesComplicationsCraniotomiesEmergent surgeryExploratory laparotomies and ERCP

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