The effect of national public health interventions for COVID‐19 on emergency general surgery in Northland, New Zealand

Abstract

Background The New Zealand government instituted escalating public health interventions to prevent the spread of COVID‐19. There was concern this would affect health seeking behaviour leading to delayed presentation and worse outcomes. The aim of this study was to examine the effects of these interventions on rate and severity of acute general surgical admissions in Northland, New Zealand. Methods A retrospective comparative cohort study was performed. Two cohorts were identified: 28 February to 8 June 2020 and same period in 2019. Data for surgical admissions and operations and emergency department (ED) presentation were obtained from the hospital data warehouse. Three index diagnoses were assessed for severity. Results There were 650 acute general surgical admissions in 2019 and 627 in 2020 ( P 0.353). Operations were performed in 226 and 224 patients respectively ( P 0.829). ED presentations decreased from 11 398 to 8743 ( P < 0.001). No difference in severity of acute appendicitis ( P 0.970), acute diverticulitis ( P 0.333) or acute pancreatitis ( P 0.803) was detected. Median length‐of‐stay, 30‐day mortality and admission diagnosis were comparable. Conclusion Despite a significant reduction in ED presentations, interventions for COVID‐19 did not result in a difference in the rate or severity of acute general surgical admissions.

The Management of Acute Colonic Diverticulitis in the COVID-19 Era: A Scoping Review

“…Another assessment performed at the Department of Radiology of the University of Massachusetts Medical School reported a reduction of uncomplicated diverticulitis ( p = 0.002), while there was no significant difference in the number of complicated diverticulitis cases ( p = 0.09) [ 23 ]. The same reduction of patients with acute diverticulitis was reported in some observational studies of patients admitted at emergency surgery units in Italy [ 21 ], New Zealand [ 38 ], and the UK [ 22 ].…”

“…The initial search produced 135 potentially relevant articles. After 85 articles were screened for relevance of titles and abstracts, 50 full text articles were further assessed for eligibility and 25 were excluded ( Supplementary Table S1 ); thus, 25 trials were included in the review [ 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 ]. Their characteristics are reported in Table 1 , Table 2 , Table 3 and Table 4 .…”

Changes in appendicitis treatment during the COVID-19 pandemic – A systematic review and meta-analysis

“…26 studies described a change in case number of appendicitis and/or appendectomies between comparable time periods before and during the COVID-19 pandemic in adults [ [16] , [17] , [18] , [19] , [20] , [21] , [22] , [23] , [24] , [25] , [26] , [27] , [28] , [29] , [30] , [31] , [32] , [33] , [34] , [35] , [36] , [37] , [38] , [39] , [40] , [41] ]. Studies were conducted in 15 countries (as shown in Fig.…”

“…Overall 25.581 patients were analysed: 18,107 before the onset of the pandemic and 7474 during the pandemic [ 16 , 18 , 20 , [23] , [24] , [25] , [26] , [27] , 30 , 31 , [34] , [35] , [36] , 41 , [54] , [55] , [56] , [57] , [58] , [59] ]. During the pandemic 26.6% of patients had complicated appendicitis, compared to 22.2% before the onset of the pandemic.…”

“…18 studies [ 11 , 16 , 18 , 24 , 26 , 27 , 30 , 31 , 35 , [39] , [40] , [41] , [53] , [54] , [55] , [56] , [57] , [58] ] described the length of hospital stay (in days) in adults before and during the COVID-19 pandemic.…”