The impact of elective surgery postponement during COVID-19 on emergency bellwether procedures in a large tertiary centre in Singapore
Abstract The coronavirus disease 2019 (COVID-19) pandemic drove many healthcare systems worldwide to postpone elective surgery to increase healthcare capacity, manpower, and reduce infection risk to staff. The aim of this study was to assess the impact of an elective surgery postponement policy in r...
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Veröffentlicht in: | International journal for quality in health care 2024-03, Vol.36 (1) |
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creator | Chan, Sze Ling Zhang, Alwin Yaoxian Lam, Sean Shao Wei Rao, Vijaya Kanagalingam, Devendra Tan, Hiang Khoon Chow, Pierce Kah Hoe Mathur, Sachin |
description | Abstract
The coronavirus disease 2019 (COVID-19) pandemic drove many healthcare systems worldwide to postpone elective surgery to increase healthcare capacity, manpower, and reduce infection risk to staff. The aim of this study was to assess the impact of an elective surgery postponement policy in response to the COVID-19 pandemic on surgical volumes and patient outcomes for three emergency bellwether procedures. A retrospective cohort study of patients who underwent any of the three emergency procedures [Caesarean section (CS), emergency laparotomy (EL), and open fracture (OF) fixation] between 1 January 2018 and 31 December 2021 was conducted using clinical and surgical data from electronic medical records. The volumes and outcomes of each surgery were compared across four time periods: pre-COVID (January 2018–January 2020), elective postponement (February–May 2020), recovery (June–November 2020), and postrecovery (December 2020–December 2021) using Kruskal–Wallis test and segmented negative binomial regression. There was a total of 3886, 1396, and 299 EL, CS, and OF, respectively. There was no change in weekly volumes of CS and OF fixations across the four time periods. However, the volume of EL increased by 47% [95% confidence interval: 26–71%, P = 9.13 × 10–7) and 52% (95% confidence interval: 25–85%, P = 3.80 × 10–5) in the recovery and postrecovery period, respectively. Outcomes did not worsen throughout the four time periods for all three procedures and some actually improved for EL from elective postponement onwards. Elective surgery postponement in the early COVID-19 pandemic did not affect volumes of emergency CS and OF fixations but led to an increase in volume for EL after the postponement without any worsening of outcomes. |
doi_str_mv | 10.1093/intqhc/mzae022 |
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The coronavirus disease 2019 (COVID-19) pandemic drove many healthcare systems worldwide to postpone elective surgery to increase healthcare capacity, manpower, and reduce infection risk to staff. The aim of this study was to assess the impact of an elective surgery postponement policy in response to the COVID-19 pandemic on surgical volumes and patient outcomes for three emergency bellwether procedures. A retrospective cohort study of patients who underwent any of the three emergency procedures [Caesarean section (CS), emergency laparotomy (EL), and open fracture (OF) fixation] between 1 January 2018 and 31 December 2021 was conducted using clinical and surgical data from electronic medical records. The volumes and outcomes of each surgery were compared across four time periods: pre-COVID (January 2018–January 2020), elective postponement (February–May 2020), recovery (June–November 2020), and postrecovery (December 2020–December 2021) using Kruskal–Wallis test and segmented negative binomial regression. There was a total of 3886, 1396, and 299 EL, CS, and OF, respectively. There was no change in weekly volumes of CS and OF fixations across the four time periods. However, the volume of EL increased by 47% [95% confidence interval: 26–71%, P = 9.13 × 10–7) and 52% (95% confidence interval: 25–85%, P = 3.80 × 10–5) in the recovery and postrecovery period, respectively. Outcomes did not worsen throughout the four time periods for all three procedures and some actually improved for EL from elective postponement onwards. Elective surgery postponement in the early COVID-19 pandemic did not affect volumes of emergency CS and OF fixations but led to an increase in volume for EL after the postponement without any worsening of outcomes.</description><identifier>ISSN: 1353-4505</identifier><identifier>EISSN: 1464-3677</identifier><identifier>DOI: 10.1093/intqhc/mzae022</identifier><identifier>PMID: 38506629</identifier><language>eng</language><publisher>UK: Oxford University Press</publisher><ispartof>International journal for quality in health care, 2024-03, Vol.36 (1)</ispartof><rights>The Author(s) 2024. Published by Oxford University Press on behalf of International Society for Quality in Health Care. 2024</rights><rights>The Author(s) 2024. Published by Oxford University Press on behalf of International Society for Quality in Health Care.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c369t-5932814284ae18c48aa4c765779ba0abb640e479f34e8d37e2d6c8ae9d7321113</citedby><cites>FETCH-LOGICAL-c369t-5932814284ae18c48aa4c765779ba0abb640e479f34e8d37e2d6c8ae9d7321113</cites><orcidid>0000-0003-4272-4595</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>315,781,785,1585,1605,27926,27927</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38506629$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Chan, Sze Ling</creatorcontrib><creatorcontrib>Zhang, Alwin Yaoxian</creatorcontrib><creatorcontrib>Lam, Sean Shao Wei</creatorcontrib><creatorcontrib>Rao, Vijaya</creatorcontrib><creatorcontrib>Kanagalingam, Devendra</creatorcontrib><creatorcontrib>Tan, Hiang Khoon</creatorcontrib><creatorcontrib>Chow, Pierce Kah Hoe</creatorcontrib><creatorcontrib>Mathur, Sachin</creatorcontrib><title>The impact of elective surgery postponement during COVID-19 on emergency bellwether procedures in a large tertiary centre in Singapore</title><title>International journal for quality in health care</title><addtitle>Int J Qual Health Care</addtitle><description>Abstract
The coronavirus disease 2019 (COVID-19) pandemic drove many healthcare systems worldwide to postpone elective surgery to increase healthcare capacity, manpower, and reduce infection risk to staff. The aim of this study was to assess the impact of an elective surgery postponement policy in response to the COVID-19 pandemic on surgical volumes and patient outcomes for three emergency bellwether procedures. A retrospective cohort study of patients who underwent any of the three emergency procedures [Caesarean section (CS), emergency laparotomy (EL), and open fracture (OF) fixation] between 1 January 2018 and 31 December 2021 was conducted using clinical and surgical data from electronic medical records. The volumes and outcomes of each surgery were compared across four time periods: pre-COVID (January 2018–January 2020), elective postponement (February–May 2020), recovery (June–November 2020), and postrecovery (December 2020–December 2021) using Kruskal–Wallis test and segmented negative binomial regression. There was a total of 3886, 1396, and 299 EL, CS, and OF, respectively. There was no change in weekly volumes of CS and OF fixations across the four time periods. However, the volume of EL increased by 47% [95% confidence interval: 26–71%, P = 9.13 × 10–7) and 52% (95% confidence interval: 25–85%, P = 3.80 × 10–5) in the recovery and postrecovery period, respectively. Outcomes did not worsen throughout the four time periods for all three procedures and some actually improved for EL from elective postponement onwards. Elective surgery postponement in the early COVID-19 pandemic did not affect volumes of emergency CS and OF fixations but led to an increase in volume for EL after the postponement without any worsening of outcomes.</description><issn>1353-4505</issn><issn>1464-3677</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>TOX</sourceid><recordid>eNqFkLtOxDAQRS0EguXRUiKXUIT1K3ZcouUprUTBo40cZ3Y3KImD7YDgA_hujHahpZqR5szR1UXomJJzSjSfNn18Xdlp92mAMLaFJlRIkXGp1Hbaec4zkZN8D-2H8EIIlTyXu2iPFzmRkukJ-npcAW66wdiI3QJDCzY2b4DD6JfgP_DgQhxcDx30Edejb_olnt0_311mVGPX43RIYG8_cAVt-w5xBR4P3llIMATc9Njg1iQGR_CxMclpk8vDz-kh6czgPByinYVpAxxt5gF6ur56nN1m8_ubu9nFPLNc6pjlmrOCClYIA7SwojBGWCVzpXRliKkqKQgIpRdcQFFzBayWtjCga8UZpZQfoNO1N0V8HSHEsmuCTclND24MJdOKKcJJwRJ6vkatdyF4WJSDb7qUv6Sk_Om-XHdfbrpPDycb91h1UP_hv2Un4GwNuHH4T_YNEaeSFA</recordid><startdate>20240321</startdate><enddate>20240321</enddate><creator>Chan, Sze Ling</creator><creator>Zhang, Alwin Yaoxian</creator><creator>Lam, Sean Shao Wei</creator><creator>Rao, Vijaya</creator><creator>Kanagalingam, Devendra</creator><creator>Tan, Hiang Khoon</creator><creator>Chow, Pierce Kah Hoe</creator><creator>Mathur, Sachin</creator><general>Oxford University Press</general><scope>TOX</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-4272-4595</orcidid></search><sort><creationdate>20240321</creationdate><title>The impact of elective surgery postponement during COVID-19 on emergency bellwether procedures in a large tertiary centre in Singapore</title><author>Chan, Sze Ling ; Zhang, Alwin Yaoxian ; Lam, Sean Shao Wei ; Rao, Vijaya ; Kanagalingam, Devendra ; Tan, Hiang Khoon ; Chow, Pierce Kah Hoe ; Mathur, Sachin</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c369t-5932814284ae18c48aa4c765779ba0abb640e479f34e8d37e2d6c8ae9d7321113</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Chan, Sze Ling</creatorcontrib><creatorcontrib>Zhang, Alwin Yaoxian</creatorcontrib><creatorcontrib>Lam, Sean Shao Wei</creatorcontrib><creatorcontrib>Rao, Vijaya</creatorcontrib><creatorcontrib>Kanagalingam, Devendra</creatorcontrib><creatorcontrib>Tan, Hiang Khoon</creatorcontrib><creatorcontrib>Chow, Pierce Kah Hoe</creatorcontrib><creatorcontrib>Mathur, Sachin</creatorcontrib><collection>Access via Oxford University Press (Open Access Collection)</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>International journal for quality in health care</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Chan, Sze Ling</au><au>Zhang, Alwin Yaoxian</au><au>Lam, Sean Shao Wei</au><au>Rao, Vijaya</au><au>Kanagalingam, Devendra</au><au>Tan, Hiang Khoon</au><au>Chow, Pierce Kah Hoe</au><au>Mathur, Sachin</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The impact of elective surgery postponement during COVID-19 on emergency bellwether procedures in a large tertiary centre in Singapore</atitle><jtitle>International journal for quality in health care</jtitle><addtitle>Int J Qual Health Care</addtitle><date>2024-03-21</date><risdate>2024</risdate><volume>36</volume><issue>1</issue><issn>1353-4505</issn><eissn>1464-3677</eissn><abstract>Abstract
The coronavirus disease 2019 (COVID-19) pandemic drove many healthcare systems worldwide to postpone elective surgery to increase healthcare capacity, manpower, and reduce infection risk to staff. The aim of this study was to assess the impact of an elective surgery postponement policy in response to the COVID-19 pandemic on surgical volumes and patient outcomes for three emergency bellwether procedures. A retrospective cohort study of patients who underwent any of the three emergency procedures [Caesarean section (CS), emergency laparotomy (EL), and open fracture (OF) fixation] between 1 January 2018 and 31 December 2021 was conducted using clinical and surgical data from electronic medical records. The volumes and outcomes of each surgery were compared across four time periods: pre-COVID (January 2018–January 2020), elective postponement (February–May 2020), recovery (June–November 2020), and postrecovery (December 2020–December 2021) using Kruskal–Wallis test and segmented negative binomial regression. There was a total of 3886, 1396, and 299 EL, CS, and OF, respectively. There was no change in weekly volumes of CS and OF fixations across the four time periods. However, the volume of EL increased by 47% [95% confidence interval: 26–71%, P = 9.13 × 10–7) and 52% (95% confidence interval: 25–85%, P = 3.80 × 10–5) in the recovery and postrecovery period, respectively. Outcomes did not worsen throughout the four time periods for all three procedures and some actually improved for EL from elective postponement onwards. Elective surgery postponement in the early COVID-19 pandemic did not affect volumes of emergency CS and OF fixations but led to an increase in volume for EL after the postponement without any worsening of outcomes.</abstract><cop>UK</cop><pub>Oxford University Press</pub><pmid>38506629</pmid><doi>10.1093/intqhc/mzae022</doi><orcidid>https://orcid.org/0000-0003-4272-4595</orcidid><oa>free_for_read</oa></addata></record> |
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title | The impact of elective surgery postponement during COVID-19 on emergency bellwether procedures in a large tertiary centre in Singapore |
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