The impacts of the COVID-19 outbreak on emergency department visits of surgical patients

BACKGROUND: The novel Coronavirus Disease 2019 (COVID-19) formed the basis for emergency department visits. This study aims to evaluate the effects of the pandemic on emergency department visits of surgical patients.
METHODS: The hospital database records of general surgery patients who presented at the emergency department in the period of March 2020-May 2020 (pandemic period) and March 2019–May 2019 (non-pandemic period) were retrospectively analyzed and compared. The primary outcome of this study was the emergency department visit rate of patients requiring a general surgery consultation. Secondary outcomes of this study were patient complaints, diagnosis and treatments, treatment rejection rate, triage category data, the effects of age and gender, and the hospitalization rate.
RESULTS: In this study, 618 patients were included: 265 patients from the pandemic period and 353 patients from the non-pandemic period. The analysis and comparison revealed that during the pandemic period, the presentation rate of female patients was lower than that of male patients (45.5% vs. 55.5%, respectively, p=0.045). The triage category rates of patient visits to the hospital during the pandemic period were higher in yellow and red, and lower in green (p<0.01). The incidence of a surgical pathology finding was higher during the pandemic period (p=0.019). The incidence of diseases related to the gastrointestinal tract was higher during the pandemic period (p=0.011). The rate of open surgery in the pandemic period was higher than that of the non-pandemic period (80.5% vs. 32.7%, respectively; p<0.01). The treatment rejection rate was also higher in the pandemic period compared with the non-pandemic period (20% vs. 3.7%, respectively; p<0.01, r). In addition, the hospitalization period was shorter in the pandemic period (p=0.021).
CONCLUSION: A 25% reduction in the number of surgical patient visits to the emergency department was observed during the COVID-19 outbreak. The biggest decrease was seen in patients with a green triage code and female patients. It is significant to evaluate the effects of the pandemic on surgical patients visited the emergency department to manage the post-epidemic period and to prepare for possible future epidemic periods.

COVID-19 salgýnýnýn cerrahi hastalarýn acil servis baþvurularý üzerine etkisi

AMAÇ: Coronavirus Hastalýðý 2019 (COVID-19) acil servis baþvurularýnýn temelini oluþturmuþtur. Bu çalýþma pandeminin acil servise baþvuran genel cerrahi hastalarýna etkisini deðerlendirmeyi amaçlamaktadýr.
GEREÇ VE YÖNTEM: Mart 2020–Mayýs 2020 (pandemi dönemi) ile Mart 2019–Mayýs 2019 (pandemi olmayan dönem) tarihleri arasýnda acil servise baþvuran genel cerrahi hastalarýnýn kayýtlarý hastane bilgisayar tabanlý veritabanýndan geriye dönük olarak incelendi. Birincil sonuç acil servis baþvuru oranlarýdýr. Ýkincil sonuçlar hastalarýn baþvuru þikayetleri, taný ve tedavileri, tedavi red oranlarý, triyaj kategorileri, yaþ ve cinsiyetin acil servis baþvuru oranlarýna etkisi ve hastanede yatýþ oranlarýdýr. Sonuçlar her iki dönemde karþýlaþtýrýlmýþtýr.
BULGULAR: Çalýþma pandemi döneminde 265 hasta, pandemi olmayan dönemde 353 hasta olmak üzere toplam 618 hastayla yapýldý. Pandemi döneminde kadýn hastalarýn baþvuru oraný, erkek hastalara göre daha düþüktü (sýrasýyla, %45.5’e karþý %55.5, p=0.045). Pandemi döneminde hastaneye baþvuran hastalarýn triyaj kategorilerinin sarý ve kýrmýzý olma oraný daha yüksek, yeþil olma oraný ise daha düþüktü (p<0.01). Pandemi dönemindeki hastalarda cerrahi patoloji görülme oraný daha fazlaydý (p=0.019). Pandemi döneminde tanýsý gastrointestinal sistem hastalýklarý olan hastalarýn oraný daha yüksekti (p=0.011). Pandemi döneminde açýk ameliyat oraný pandemi olmayan döneme göre daha yüksekti (sýrasýyla, %80.5’e karþý %32.7, p<0.01). Tedavi red oraný pandemi döneminde pandemi olmayan döneme göre daha yüksekti (sýrasýyla, %20’ye karþý %3.7, p<0.01). Hastanede yatýþ süreleri pandemi döneminde daha düþüktü (p=0.021).
TARTIÞMA: COVID-19 salgýný sýrasýnda cerrahi hastalarýn acil servis baþvurularýnda %25 oranýnda azalma saptandý. En büyük düþüþ yeþil alan baþvurularýnda ve kadýn hasta baþvurularýnda görüldü. Pandeminin acil servise baþvuran cerrahi hastalar üzerindeki etkisini deðerlendirmek hem salgýn sonrasý dönemde hem de olasý gelecek salgýn dönemlerine hazýrlýk açýsýndan önemlidir.