Impact of COVID-19 Governmental Restrictions on Emergency General Surgery Operative Volume and Severity

Abstract

Background To describe the effect of the COVID-19 pandemic on emergency general surgery operative volumes during governmental shutdowns secondary to the pandemic and characterize differences in disease severity, morbidity, and mortality during this time compared to previous years. Methods This retrospective cohort study compares patients who underwent emergency general surgery operations at a tertiary hospital from March 1st to May 31st of 2020 to 2019. Average emergent cases per day were analyzed, comparing identical date ranges between 2020 (pandemic group) and 2019 (control group). Secondary analysis was performed analyzing disease severity, morbidity, and mortality. Results From March 1st to May 31st, 2020, 2.5 emergency general surgery operations were performed on average daily compared to 3.0 operations on average daily in 2019, a significant decrease ( P = .03). No significant difference was found in presenting disease severity, morbidity, or mortality between the pandemic and control groups. Discussion This study demonstrates a decrease of 65% in emergency general surgery operations during governmental restrictions secondary to the COVID-19 pandemic. This decrease in operations was not associated with worse disease severity, morbidity, or mortality.

Perceptions Regarding the SARS-CoV-2 Pandemic’s Impact on Neurocritical Care Delivery: Results From a Global Survey

“…When facing the anticipated first surge, many ICUs shifted priorities to accommodate COVID-19 patients,38 balancing the care of critically ill COVID-19 and non-COVID-19 patients 39. There are conflicting data on disease severity and mortality in the pandemic period compared with prepandemic trends 40–43. Early in the pandemic, critical care capacity for NCC patients was preserved by a temporary suspension of elective non-neurological and neurological surgeries, including elective endovascular, cranioplasty, and open cerebrovascular procedures 44,45.…”

“…39 There are conflicting data on disease severity and mortality in the pandemic period compared with prepandemic trends. [40][41][42][43] Early in the pandemic, critical care capacity for NCC patients was preserved by a temporary suspension of elective non-neurological and neurological surgeries, including elective endovascular, cranioplasty, and open cerebrovascular procedures. 44,45 Strategies to generate additional staffing for ICU teams included: (a) reallocation or redeployment of existing ICU clinicians by specialty and subspecialty training; (b) utilization of non-ICU based clinicians, such as registered certified nurse anesthetists, to participate in routine critical care delivery; (c) return to work of retired physicians and nurses, 9 and; (d) recruitment of traveler nurses or per diem personnel.…”

Impact of Covid-19 pandemic on volume and surgeon professional fees generated by emergency general surgery procedures

“…used data from a level 1 trauma center and reported a decline in ED visits for syncope, cerebrovascular accidents, urolithiasis, abdominal and back pain, and this trend was more prominent in pediatric and elderly population [ 5 ]. More recently, Lund et al reported a decrease in 65% of emergency general surgeries during the COVID-19 governmental restrictions [ 6 ].…”