Acute Care Surgery during the COVID-19 pandemic in Spain: Changes in volume, causes and complications. A multicentre retrospective cohort study
during the COVID-19 pandemic, the number of Acute Care Surgery procedures performed in Spanish hospitals decreased significantly. The aim of this study was to compare Acute Care Surgery activity during the COVID-19 pandemic and during a control period. a multicenter retrospective cohort study was pe...
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| Veröffentlicht in: | International journal of surgery (London, England) England), 2020-08, Vol.80, p.157-161 |
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| creator | Cano-Valderrama, Oscar Morales, Xavier Ferrigni, Carlos J. Martín-Antona, Esteban Turrado, Victor García, Alejandro Cuñarro-López, Yolanda Zarain-Obrador, Leire Duran-Poveda, Manuel Balibrea, José M. Torres, Antonio J. |
| description | during the COVID-19 pandemic, the number of Acute Care Surgery procedures performed in Spanish hospitals decreased significantly. The aim of this study was to compare Acute Care Surgery activity during the COVID-19 pandemic and during a control period.
a multicenter retrospective cohort study was performed including patients who underwent Acute Care Surgery in three tertiary care hospitals in Spain during a control (11th March 2019 to 21st April 2019) and a pandemic (16th March 2020 to 26th April 2020) period. Type of surgical procedures, patients' features and postoperative complications were compared.
two hundred and eighty-five and 117 patients were included in each group. Mean number of patients who underwent Acute Care Surgery during the control and pandemic periods was 2.3 and 0.9 patients per day and hospital (p |
| doi_str_mv | 10.1016/j.ijsu.2020.07.002 |
| format | Article |
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a multicenter retrospective cohort study was performed including patients who underwent Acute Care Surgery in three tertiary care hospitals in Spain during a control (11th March 2019 to 21st April 2019) and a pandemic (16th March 2020 to 26th April 2020) period. Type of surgical procedures, patients' features and postoperative complications were compared.
two hundred and eighty-five and 117 patients were included in each group. Mean number of patients who underwent Acute Care Surgery during the control and pandemic periods was 2.3 and 0.9 patients per day and hospital (p < 0.001), representing a 58.9% decrease in Acute Care Surgery activity. Time from symptoms onset to patient arrival at the Emergency Department was longer during the pandemic (44.6 vs. 71.0 h, p < 0.001). Surgeries due to acute cholecystitis and complications from previous elective procedures decreased (26.7% vs. 9.4%) during the pandemic, while bowel obstructions and abdominal wall hernia surgeries increased (12.3% vs. 22.2%) (p = 0.001). Morbidity was higher during pandemic period (34.7% vs. 47.1%, p = 0.022), although this difference was not statistically significant in the multivariate analysis. Reoperation rate (17.9% vs. 12.8%, p = 0.212) and mortality (6.7% vs. 4.3%, p = 0.358) were similar in both groups.
during the COVID-19 pandemic, a significant reduction in the performance of Acute Care Surgery procedures was observed. Moreso, a longer time from symptoms onset to patient arrival at the Emergency Department was noted. Higher morbidity was observed in patients undergoing Acute Care Surgery during the pandemic period, although there was not any difference in mortality or reoperation rate.
•Acute Care Surgery Activity was decreased during the COVID-19 pandemic.•A higher delay of the patients presenting in the Emergency Department was observed during the pandemic period.•During the COVID-19 pandemic, a higher morbidity rate was found in patients undergoing Acute Care Surgery.</description><identifier>ISSN: 1743-9191</identifier><identifier>EISSN: 1743-9159</identifier><identifier>DOI: 10.1016/j.ijsu.2020.07.002</identifier><identifier>PMID: 32679205</identifier><language>eng</language><publisher>England: Elsevier Ltd</publisher><subject>Abdominal Wall ; Abscess - epidemiology ; Abscess - surgery ; Acute care surgery ; Acute Disease ; Appendectomy - statistics & numerical data ; Appendicitis - epidemiology ; Appendicitis - surgery ; Betacoronavirus ; Cholecystitis, Acute - epidemiology ; Cholecystitis, Acute - surgery ; Cohort Studies ; Comorbidity ; Coronavirus Infections - epidemiology ; COVID-19 ; Diabetes Mellitus - epidemiology ; Dyslipidemias - epidemiology ; Emergencies ; Emergency surgery ; Female ; Hernia, Abdominal - epidemiology ; Hernia, Abdominal - surgery ; Herniorrhaphy - statistics & numerical data ; Humans ; Hypertension - epidemiology ; Intestinal Obstruction - epidemiology ; Intestinal Obstruction - surgery ; Laparoscopy - statistics & numerical data ; Logistic Models ; Male ; Middle Aged ; Mortality ; Myocardial Ischemia - epidemiology ; Pandemic ; Pandemics ; Pneumonia, Viral - epidemiology ; Postoperative Complications - epidemiology ; Rectal Diseases - epidemiology ; Rectal Diseases - surgery ; Reoperation - statistics & numerical data ; Retrospective Studies ; SARS-CoV-2 ; Spain - epidemiology ; Time-to-Treatment - statistics & numerical data</subject><ispartof>International journal of surgery (London, England), 2020-08, Vol.80, p.157-161</ispartof><rights>2020 IJS Publishing Group Ltd</rights><rights>Copyright © 2020 IJS Publishing Group Ltd. Published by Elsevier Ltd. All rights reserved.</rights><rights>2020 IJS Publishing Group Ltd. Published by Elsevier Ltd. All rights reserved. 2020 IJS Publishing Group Ltd</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c521t-a2b2ec24b246caf2ac11a450fbccfd00bb6aeaaceb2bb1dc1c062bc8717d09173</citedby><cites>FETCH-LOGICAL-c521t-a2b2ec24b246caf2ac11a450fbccfd00bb6aeaaceb2bb1dc1c062bc8717d09173</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.ijsu.2020.07.002$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>230,314,780,784,885,3550,27924,27925,45995</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32679205$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Cano-Valderrama, Oscar</creatorcontrib><creatorcontrib>Morales, Xavier</creatorcontrib><creatorcontrib>Ferrigni, Carlos J.</creatorcontrib><creatorcontrib>Martín-Antona, Esteban</creatorcontrib><creatorcontrib>Turrado, Victor</creatorcontrib><creatorcontrib>García, Alejandro</creatorcontrib><creatorcontrib>Cuñarro-López, Yolanda</creatorcontrib><creatorcontrib>Zarain-Obrador, Leire</creatorcontrib><creatorcontrib>Duran-Poveda, Manuel</creatorcontrib><creatorcontrib>Balibrea, José M.</creatorcontrib><creatorcontrib>Torres, Antonio J.</creatorcontrib><title>Acute Care Surgery during the COVID-19 pandemic in Spain: Changes in volume, causes and complications. A multicentre retrospective cohort study</title><title>International journal of surgery (London, England)</title><addtitle>Int J Surg</addtitle><description>during the COVID-19 pandemic, the number of Acute Care Surgery procedures performed in Spanish hospitals decreased significantly. The aim of this study was to compare Acute Care Surgery activity during the COVID-19 pandemic and during a control period.
a multicenter retrospective cohort study was performed including patients who underwent Acute Care Surgery in three tertiary care hospitals in Spain during a control (11th March 2019 to 21st April 2019) and a pandemic (16th March 2020 to 26th April 2020) period. Type of surgical procedures, patients' features and postoperative complications were compared.
two hundred and eighty-five and 117 patients were included in each group. Mean number of patients who underwent Acute Care Surgery during the control and pandemic periods was 2.3 and 0.9 patients per day and hospital (p < 0.001), representing a 58.9% decrease in Acute Care Surgery activity. Time from symptoms onset to patient arrival at the Emergency Department was longer during the pandemic (44.6 vs. 71.0 h, p < 0.001). Surgeries due to acute cholecystitis and complications from previous elective procedures decreased (26.7% vs. 9.4%) during the pandemic, while bowel obstructions and abdominal wall hernia surgeries increased (12.3% vs. 22.2%) (p = 0.001). Morbidity was higher during pandemic period (34.7% vs. 47.1%, p = 0.022), although this difference was not statistically significant in the multivariate analysis. Reoperation rate (17.9% vs. 12.8%, p = 0.212) and mortality (6.7% vs. 4.3%, p = 0.358) were similar in both groups.
during the COVID-19 pandemic, a significant reduction in the performance of Acute Care Surgery procedures was observed. Moreso, a longer time from symptoms onset to patient arrival at the Emergency Department was noted. Higher morbidity was observed in patients undergoing Acute Care Surgery during the pandemic period, although there was not any difference in mortality or reoperation rate.
•Acute Care Surgery Activity was decreased during the COVID-19 pandemic.•A higher delay of the patients presenting in the Emergency Department was observed during the pandemic period.•During the COVID-19 pandemic, a higher morbidity rate was found in patients undergoing Acute Care Surgery.</description><subject>Abdominal Wall</subject><subject>Abscess - epidemiology</subject><subject>Abscess - surgery</subject><subject>Acute care surgery</subject><subject>Acute Disease</subject><subject>Appendectomy - statistics & numerical data</subject><subject>Appendicitis - epidemiology</subject><subject>Appendicitis - surgery</subject><subject>Betacoronavirus</subject><subject>Cholecystitis, Acute - epidemiology</subject><subject>Cholecystitis, Acute - surgery</subject><subject>Cohort Studies</subject><subject>Comorbidity</subject><subject>Coronavirus Infections - epidemiology</subject><subject>COVID-19</subject><subject>Diabetes Mellitus - epidemiology</subject><subject>Dyslipidemias - epidemiology</subject><subject>Emergencies</subject><subject>Emergency surgery</subject><subject>Female</subject><subject>Hernia, Abdominal - epidemiology</subject><subject>Hernia, Abdominal - surgery</subject><subject>Herniorrhaphy - statistics & numerical data</subject><subject>Humans</subject><subject>Hypertension - epidemiology</subject><subject>Intestinal Obstruction - epidemiology</subject><subject>Intestinal Obstruction - surgery</subject><subject>Laparoscopy - statistics & numerical data</subject><subject>Logistic Models</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Mortality</subject><subject>Myocardial Ischemia - epidemiology</subject><subject>Pandemic</subject><subject>Pandemics</subject><subject>Pneumonia, Viral - epidemiology</subject><subject>Postoperative Complications - epidemiology</subject><subject>Rectal Diseases - epidemiology</subject><subject>Rectal Diseases - surgery</subject><subject>Reoperation - statistics & numerical data</subject><subject>Retrospective Studies</subject><subject>SARS-CoV-2</subject><subject>Spain - epidemiology</subject><subject>Time-to-Treatment - statistics & numerical data</subject><issn>1743-9191</issn><issn>1743-9159</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kc2O0zAUhS0EYoaBF2CBvGRBgu2kSYPQSFX5G2mkWQywteybm9ZVYgf_VOpT8Mq4dKhgw8rW8XfPvb6HkJeclZzx5u2uNLuQSsEEK1lbMiYekUve1lXR8UX3-Hzv-AV5FsKOsZot-fIpuahE03aCLS7JzxWkiHStPNL75DfoD7RP3tgNjdus332_-VDwjs7K9jgZoMbS-1kZ-46ut8puMByVvRvThG8oqBSyklkKbppHAyoaZ0NJV3RKYzSANuZOHqN3YUaIZo8Z3TofaYipPzwnTwY1BnzxcF6Rb58-fl1_KW7vPt-sV7cFLASPhRJaIIhai7oBNQgFnKt6wQYNMPSMad0oVApQC615DxxYIzQsW972rONtdUWuT75z0hP2v-dSo5y9mZQ_SKeM_PfFmq3cuL1sq4ZzLrLB6wcD734kDFFOJgCOo7LoUpCiFnXXVdWSZVScUMifDh6HcxvO5DFJuZPHJOUxSclamZPMRa_-HvBc8ie6DLw_AZjXtDfoZQCDFrA3Pi9W9s78z_8XuIGzzw</recordid><startdate>20200801</startdate><enddate>20200801</enddate><creator>Cano-Valderrama, Oscar</creator><creator>Morales, Xavier</creator><creator>Ferrigni, Carlos J.</creator><creator>Martín-Antona, Esteban</creator><creator>Turrado, Victor</creator><creator>García, Alejandro</creator><creator>Cuñarro-López, Yolanda</creator><creator>Zarain-Obrador, Leire</creator><creator>Duran-Poveda, Manuel</creator><creator>Balibrea, José M.</creator><creator>Torres, Antonio J.</creator><general>Elsevier Ltd</general><general>IJS Publishing Group Ltd. 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A multicentre retrospective cohort study</title><author>Cano-Valderrama, Oscar ; Morales, Xavier ; Ferrigni, Carlos J. ; Martín-Antona, Esteban ; Turrado, Victor ; García, Alejandro ; Cuñarro-López, Yolanda ; Zarain-Obrador, Leire ; Duran-Poveda, Manuel ; Balibrea, José M. ; Torres, Antonio J.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c521t-a2b2ec24b246caf2ac11a450fbccfd00bb6aeaaceb2bb1dc1c062bc8717d09173</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Abdominal Wall</topic><topic>Abscess - epidemiology</topic><topic>Abscess - surgery</topic><topic>Acute care surgery</topic><topic>Acute Disease</topic><topic>Appendectomy - statistics & numerical data</topic><topic>Appendicitis - epidemiology</topic><topic>Appendicitis - surgery</topic><topic>Betacoronavirus</topic><topic>Cholecystitis, Acute - epidemiology</topic><topic>Cholecystitis, Acute - surgery</topic><topic>Cohort Studies</topic><topic>Comorbidity</topic><topic>Coronavirus Infections - epidemiology</topic><topic>COVID-19</topic><topic>Diabetes Mellitus - epidemiology</topic><topic>Dyslipidemias - epidemiology</topic><topic>Emergencies</topic><topic>Emergency surgery</topic><topic>Female</topic><topic>Hernia, Abdominal - epidemiology</topic><topic>Hernia, Abdominal - surgery</topic><topic>Herniorrhaphy - statistics & numerical data</topic><topic>Humans</topic><topic>Hypertension - epidemiology</topic><topic>Intestinal Obstruction - epidemiology</topic><topic>Intestinal Obstruction - surgery</topic><topic>Laparoscopy - statistics & numerical data</topic><topic>Logistic Models</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Mortality</topic><topic>Myocardial Ischemia - epidemiology</topic><topic>Pandemic</topic><topic>Pandemics</topic><topic>Pneumonia, Viral - epidemiology</topic><topic>Postoperative Complications - epidemiology</topic><topic>Rectal Diseases - epidemiology</topic><topic>Rectal Diseases - surgery</topic><topic>Reoperation - statistics & numerical data</topic><topic>Retrospective Studies</topic><topic>SARS-CoV-2</topic><topic>Spain - epidemiology</topic><topic>Time-to-Treatment - statistics & numerical data</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Cano-Valderrama, Oscar</creatorcontrib><creatorcontrib>Morales, Xavier</creatorcontrib><creatorcontrib>Ferrigni, Carlos J.</creatorcontrib><creatorcontrib>Martín-Antona, Esteban</creatorcontrib><creatorcontrib>Turrado, Victor</creatorcontrib><creatorcontrib>García, Alejandro</creatorcontrib><creatorcontrib>Cuñarro-López, Yolanda</creatorcontrib><creatorcontrib>Zarain-Obrador, Leire</creatorcontrib><creatorcontrib>Duran-Poveda, Manuel</creatorcontrib><creatorcontrib>Balibrea, José M.</creatorcontrib><creatorcontrib>Torres, Antonio J.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>International journal of surgery (London, England)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Cano-Valderrama, Oscar</au><au>Morales, Xavier</au><au>Ferrigni, Carlos J.</au><au>Martín-Antona, Esteban</au><au>Turrado, Victor</au><au>García, Alejandro</au><au>Cuñarro-López, Yolanda</au><au>Zarain-Obrador, Leire</au><au>Duran-Poveda, Manuel</au><au>Balibrea, José M.</au><au>Torres, Antonio J.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Acute Care Surgery during the COVID-19 pandemic in Spain: Changes in volume, causes and complications. A multicentre retrospective cohort study</atitle><jtitle>International journal of surgery (London, England)</jtitle><addtitle>Int J Surg</addtitle><date>2020-08-01</date><risdate>2020</risdate><volume>80</volume><spage>157</spage><epage>161</epage><pages>157-161</pages><issn>1743-9191</issn><eissn>1743-9159</eissn><abstract>during the COVID-19 pandemic, the number of Acute Care Surgery procedures performed in Spanish hospitals decreased significantly. The aim of this study was to compare Acute Care Surgery activity during the COVID-19 pandemic and during a control period.
a multicenter retrospective cohort study was performed including patients who underwent Acute Care Surgery in three tertiary care hospitals in Spain during a control (11th March 2019 to 21st April 2019) and a pandemic (16th March 2020 to 26th April 2020) period. Type of surgical procedures, patients' features and postoperative complications were compared.
two hundred and eighty-five and 117 patients were included in each group. Mean number of patients who underwent Acute Care Surgery during the control and pandemic periods was 2.3 and 0.9 patients per day and hospital (p < 0.001), representing a 58.9% decrease in Acute Care Surgery activity. Time from symptoms onset to patient arrival at the Emergency Department was longer during the pandemic (44.6 vs. 71.0 h, p < 0.001). Surgeries due to acute cholecystitis and complications from previous elective procedures decreased (26.7% vs. 9.4%) during the pandemic, while bowel obstructions and abdominal wall hernia surgeries increased (12.3% vs. 22.2%) (p = 0.001). Morbidity was higher during pandemic period (34.7% vs. 47.1%, p = 0.022), although this difference was not statistically significant in the multivariate analysis. Reoperation rate (17.9% vs. 12.8%, p = 0.212) and mortality (6.7% vs. 4.3%, p = 0.358) were similar in both groups.
during the COVID-19 pandemic, a significant reduction in the performance of Acute Care Surgery procedures was observed. Moreso, a longer time from symptoms onset to patient arrival at the Emergency Department was noted. Higher morbidity was observed in patients undergoing Acute Care Surgery during the pandemic period, although there was not any difference in mortality or reoperation rate.
•Acute Care Surgery Activity was decreased during the COVID-19 pandemic.•A higher delay of the patients presenting in the Emergency Department was observed during the pandemic period.•During the COVID-19 pandemic, a higher morbidity rate was found in patients undergoing Acute Care Surgery.</abstract><cop>England</cop><pub>Elsevier Ltd</pub><pmid>32679205</pmid><doi>10.1016/j.ijsu.2020.07.002</doi><tpages>5</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | International journal of surgery (London, England), 2020-08, Vol.80, p.157-161 |
| issn | 1743-9191 1743-9159 |
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| source | MEDLINE; Access via ScienceDirect (Elsevier); EZB-FREE-00999 freely available EZB journals |
| subjects | Abdominal Wall Abscess - epidemiology Abscess - surgery Acute care surgery Acute Disease Appendectomy - statistics & numerical data Appendicitis - epidemiology Appendicitis - surgery Betacoronavirus Cholecystitis, Acute - epidemiology Cholecystitis, Acute - surgery Cohort Studies Comorbidity Coronavirus Infections - epidemiology COVID-19 Diabetes Mellitus - epidemiology Dyslipidemias - epidemiology Emergencies Emergency surgery Female Hernia, Abdominal - epidemiology Hernia, Abdominal - surgery Herniorrhaphy - statistics & numerical data Humans Hypertension - epidemiology Intestinal Obstruction - epidemiology Intestinal Obstruction - surgery Laparoscopy - statistics & numerical data Logistic Models Male Middle Aged Mortality Myocardial Ischemia - epidemiology Pandemic Pandemics Pneumonia, Viral - epidemiology Postoperative Complications - epidemiology Rectal Diseases - epidemiology Rectal Diseases - surgery Reoperation - statistics & numerical data Retrospective Studies SARS-CoV-2 Spain - epidemiology Time-to-Treatment - statistics & numerical data |
| title | Acute Care Surgery during the COVID-19 pandemic in Spain: Changes in volume, causes and complications. A multicentre retrospective cohort study |
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