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A prospective cohort study of the impact of covid19 world pandemic on the management of emergency surgical pathology

28 Aug, 2020

Editor

The global pandemic due to the SARS‐Cov‐2 virus is having an unprecedented impact on surgical procedures1. Despite having started multiple analyzes on surgery during the pandemic2, there have been no studies on the impact of its on the management of emergency surgical pathology. Thus, a comparative cohort study of prospective databases was done. Study group (n = 127) included emergency surgeries done during COVID‐19 pandemic: between March 11, 2020 (declaration of a global pandemic by the WHO) and April 17 (start of “de‐escalation” in Spain). Results were compared with a control group (n = 307) that included emergency surgeries done during the same period in the previous year 2019.

Regarding the overall number of patients attended at emergency department for surgical pathology (n = 434), a significant decrease in the total number of its patients was observed during pandemic period (44,6% less than in 2019). The mean waiting time in the emergency department, was significantly shorter during pandemic (3·3 ± 2·15 hours vs 5·2 ± 6·13 hours; p = 0·01), probably related to the decrease in the no‐COVID activity in the emergency department during confinement status.

Both groups showed similar demographic data. Emergency pathologies, were classified as complicated or uncomplicated3. An increase in preoperative complicated diagnosis was observed during pandemic (50% vs 38·3%; p = 0·09).

Overall comparation showed that there was an increase in the complications rate during pandemic (36·2% vs 4·1%; p = 0·04) with an increase of 7·5 days in ICU stay. Nevertheless, mortality was lower in patients operated during pandemic (2·5% vs 7%).



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