Changes in volumes and severity of surgical urgencies during the first two COVID-19 pandemic waves in a regional hospital network.
Keywords:
Surgery, Urgent surgery, COVID-19, Pandemic Phases.Abstract
Background and aim This study analyses the impact of the first two pandemic waves on surgical urgencies/emergencies and their consequences on an entire provincial hospital network's surgical activities.
Methods Clinical and epidemiological data of urgent/emergent surgical admissions and interventions in the Autonomous Province of Trento's hospital network were collected from the internal common electronic database. The investigation periods were March-May 2019 (reference period), March-May 2020 (phase-I), June - August 2020 (phase-II), and October - December 2020 (phase-III). The same data were divided and grouped for the six most represented diagnoses.
Results: The number of admissions for surgical emergencies in the studied periods showed a sinusoidal trend. In the reference period of 2019, 957 patients were admitted in urgency, while in the three pandemic phases, urgent admissions were 511, 888 and 633 respectively (-47% in phase I, - 8% in phase II, -34% in phase III). This trend was also observed by stratifying admissions for single disease, except for gastrointestinal perforations and pancreatitis, which showed a slight increasing trend in phase-I. Among the studied population, the surgical rate was 35.2% in phase-I and 34.3% in phase-III; these data were significantly higher than in 2019 (25.6%).
Conclusions The effect of the COVID pandemic on surgical emergencies and urgencies (SUEs) was mainly indirect, manifesting itself with a significant reduction in the number of surgical admissions, particularly in phases-I and-III. Conversely, in the same phases, the surgical rate showed a significant increase compared to 2019.
References
2. Rausei S, Ferrara F, Zurleni T, Frattini F, Chiara O, Pietrabissa A, Sarro G. Dramatic decrease of surgical emergencies during COVID-19 outbreak. 6, 2020, J Trauma Acute Care Surg, Vol. 89, p. 1085-91.
3. R, Jones. Hospital bed occupancy demystified. 6, 2011, British Journal of Healthcare Management , Vol. 17, p. 242-248.
4. Di Marzo F, Sartelli M, Cennamo R, Toccafondi G, Coccolini F, La Torre G, Tulli G, Lombardi M, Cardi M. Recommendations for general surgery activities in a pandemic scenario (SARS-CoV-2). 2020, Br J Surg, Vol. 17, p. 1104–1106.
5. De Simone B, Chouillard E, Di Saverio S, et al. Emergency surgery during the COVID-19 pandemic: what you need to know for practice. 5, 2020, Ann R Coll Surg Engl. , Vol. 102, p. 323–332.
6. pandemic., COVIDSurg Collaborative. Global guidance for surgical care during the COVID-19. Br J Surg. [published online April 15, 2020]. doi:10.1002/bjs.11646..
7.EpiCentro - Istituto Superiore della Sanità - L'epidemiologia per la sanità pubblica - ISS. [Online] https://www.epicentro.iss.it/passi/.
8. Gruppo Tecnico Nazionale PASSI e PASSI d’Argento, Istituto Superiore di sanità. https://www.epicentro.iss.it/passi-argento/pdf2020/PASSI-PdA-COVID19-p. PASSI e PASSI d’Argento e la pandemia COVID-19 - Primo Report nazionale dal Modulo COVID. [Online] 12 2020.
9. Dr Rob Findlay, Director, Gooroo Limited. ECIST guidance - NHS England and NHS Improvement. Planning beds, bed occupancy and risk. [Online] Version number: 1.0, May 2019. https://gooroo.co.uk/wp-content/uploads/2019/08/Planning_beds_bed_occupancy_and_risk.pdf.
10. AD, Keegan. Hospital bed occupancy: More than queuing for a bed. 5, September 2010, The Medical journal of Australia, Vol. 193, p. 291-3.
11. Kaier K, Mutters NT, Frank U. Bed occupancy rates and hospital-acquired infections-should beds be kept empty? 10, June 2012, Clinical Microbiology and Infection, Vol. 18, p. 941-5.
12. Ugglas BA, Djärv T, Ljungman PLS, Holzmann MJ. Association Between Hospital Bed Occupancy and Outcomes in Emergency Care: A Cohort Study in Stockholm Region, Sweden, 2012 to 2016. 2, Aug 2020, Ann Emerg Med, Vol. 76, p. 179-190.
Downloads
Published
Issue
Section
License
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Transfer of Copyright and Permission to Reproduce Parts of Published Papers.
Authors retain the copyright for their published work. No formal permission will be required to reproduce parts (tables or illustrations) of published papers, provided the source is quoted appropriately and reproduction has no commercial intent. Reproductions with commercial intent will require written permission and payment of royalties.
How to Cite
