Prioritizing rapid COVID-19 testing in emergency general surgery patients decreases burden of inpatient hospital admission

ObjectivesThe COVID-19 pandemic has changed delivery of emergency general surgery (EGS) and contributed to widespread bed shortages. At our institution, rapid testing is not routinely approved for EGS patients. We examined common EGS conditions (appendicitis and acute cholecystitis), hypothesizing that necessity of testing for COVID-19 significantly delayed operative intervention.MethodsWe performed a prepost study to examine a 2-month timeframe, or historical control, prior to COVID-19 testing (January 1, 2020–March 1, 2020) as well as a 2-month timeframe during the COVID-19 era (January 1, 2021–March 1, 2021). We chose conditions that are frequently treated surgically as outpatient or observation status. We examined time for COVID-19 test to result, and associated time to operative intervention (operating room (OR)) and need for admission.ResultsMedian time to COVID-19 test results was 7.4 hours (IQR 5.8–13.1). For appendectomy, time to surgical consultation or case request did not differ between cohorts. Time to OR after case request was significantly longer (12.5 vs 1.9 hours, p