Impact of the COVID-19 pandemic on emergency general surgery outcomes: A single-center retrospective cohort study

BACKGROUND: The COVID-19 pandemic has affected the health-care system unpredictably. Restrictions and precautions have had a significant impact on the volume and nature of admissions in emergency services. In this study, we hypothesized that the pandemic would result in a change in the number of emergencies admitted to the general surgery inpatient service and a worse patient outcome compared to the previous year.
METHODS: A retrospective analysis of emergency general surgical admissions during the first 6 months of the pandemic and the same period in 2019 was conducted. Demographics, laboratory assessments, diagnosis, treatment strategies, and postoperative out-comes were analyzed.
RESULTS: 761 patients were admitted to the general surgery service during two 6-month periods (392 vs. 369, respectively). This represented a 5.9% reduction in admissions. However, in the first 2 months of the pandemic, the number of emergency general surgical admissions decreased by 37.1% and 43.7%, respectively. Comparison of periods demonstrated no significant differences in demograph-ics, laboratory values, incidence of emergencies, treatment strategies, and hospital stay. Acute appendicitis, cholecystitis, and bowel obstruction were the three most common surgical emergencies in the pandemic. However, there was no significant difference in outcomes between the periods when each surgical emergency was evaluated separately.
CONCLUSION: Pandemic appears to affect general surgical admissions with a fluctuating pattern, an increasing trend following a sig-nificant 2-month decrease. These findings suggest that patients presented with a delayed presentation; however, contrary to concerns, there was no difference in patient outcomes between the two periods. This study provides a perspective in management strategies for surgical emergencies in such unusual conditions.

COVID-19 salgýnýnýn acil genel cerrahi sonuçlarýna etkisi: Tek merkezli geriye dönük bir kohort çalýþmasý

AMAÇ: COVID-19 salgýný saðlýk sistemini öngörülemeyecek düzeyde etkilemektedir. Kýsýtlamalar ve önlemler, acil servislere hasta kabullerinin hacmi ve niteliði üzerinde önemli etkilere yol açmýþtýr. Bu çalýþmada, önceki yýla göre, pandeminin genel cerrahi servisine kabul edilen acil vakalarýn sayýsýnda deðiþikliðe ve daha kötü hasta sonuçlarýna neden olacaðý varsayýmýnda bulunduk.
GEREÇ VE YÖNTEM: Pandeminin ilk altý ayýnda ve 2019 yýlýnýn ayný döneminde acil genel cerrahi baþvurularýnýn geriye dönük analizi yapýldý. Demog-rafik bilgiler, laboratuvar deðerlendirmeleri, taný, tedavi stratejileri ve ameliyat sonrasý hasta sonuçlarý analiz edildi.
BULGULAR: Altý aylýk iki dönem sürecinde 761 hasta genel cerrahi servisine kabul edildi (sýrasýyla, 392 ve 369). Bu sonuç, hasta kabullerinde %5.9’luk bir azalma olduðunu gösterdi. Ancak pandeminin ilk iki ayýnda acil genel cerrahi baþvurularýnda sýrasýyla %37.1 ve %43.7 azalma görüldü. Ýki dönem karþýlaþtýrýldýðýnda, demografik özellikler, laboratuvar sonuçlarý, acil cerrahi hastalýklarýn insidansý, tedavi stratejileri ve hastanede kalýþ süreleri açýsýndan önemli bir fark saptanmadý. Akut apandisit, kolesistit ve baðýrsak týkanýklýðý pandemide en sýk görülen üç acil cerrahi durumdu. Bununla birlikte, her acil cerrahi durum ayrý ayrý deðerlendirildiðinde de dönemler arasýnda hasta sonuçlarý açýsýndan anlamlý bir fark saptanmadý. TARTIÞMA: Pandeminin, genel cerrahi baþvurularýný iki aylýk önemli bir azalmanýn ardýndan artan bir eðilim sergileyerek dalgalý bir modelle etkilediði görülmektedir. Bu bulgular, hastalarýn baþvurularýnda bir gecikme olduðunu düþündürse de endiþelerin aksine, iki dönem arasýnda hasta sonuçlarý açýsýndan bir fark yoktur. Bu çalýþma, bu tür olaðandýþý koþullarda acil cerrahi durumlar için yönetim stratejilerine bir bakýþ açýsý saðlamaktadýr.