ABSTRACT
Background and purpose: Many studies suggest that surgery in patients with COVID-19 increases the risk of complications and mortality after surgery. The purpose of this research was to compare the frequency of outcomes during and after surgery between patients with and without COVID-19 undergoing emergency surgery in Gonbad Kavus hospitals, 2020-2021. Materials and methods: In this cross-sectional study, two groups of adults (n= 114) with and without COVID-19 (group A and group B, respectively) who underwent emergency surgery were examined. Demographic data, laboratory findings, and during and post-operative outcomes were recorded. Data analysis was done in SPSS V26. Results: Average age and weight in group A (45.5 years, 78.3±16.6 Kg, respectively) were found to be higher than those in group B (39.3 years and 67.9±11.5 Kg, respectively). Significant difference was seen in the percentage of arterial blood oxygen saturation after operations between group A (94.7±1.38) and group B (91.7±2.83) (P<0.0001). Also, mean ICU and hospital length of stay were significantly longer in group A (8.5 and 9.8 days, respectively) compared with group B (5.4 and 6 days, respectively) (P<0.0001). Moreover, death was observed more in group A (76%) than group B (23%) (P=0.041). Conclusion: All members of the surgical team are required to pay special attention to the increase in the incidence of complications during and after surgery in patients with COVID-19 undergoing emergency surgery in order to take necessary preventive and therapeutic measures. © 2022, Mazandaran University of Medical Sciences. All rights reserved.
ABSTRACT
Every pandemic may cause the excessive demand for healthcare facilities and systems, while also increasing the workload of healthcare providers. On the other hand, the limited resources available to provide healthcare services to patients are a major challenge in this regard, which often emerges within the first days of the pandemic when the healthcare system is unexpectedly faced with a large number of patients without access to sufficient equipment, staff, and facilities. As such, the healthcare system or patients may suffer numerous consequences due to unpreparedness. Incidentally, although everyone is susceptible to a COVID-19, the elderly are more susceptible due to comorbidities and frailty. So far, the highest mortality rate of the disease has been reported in the elderly, especially those with severe illnesses and immune deficiency. Currently, no definite treatments or vaccines are available for COVID-19, and recommendations mostly revolve around self-isolation and the observance of personal hygiene. To the elderly with cognitive impairment, functional dependence, or living alone, it might be difficult to follow instructions, stay updated on the news, or detect the signs or symptoms of the infection. Consequently, these individuals may be faced with challenges in communicating and explaining their pain or uneasiness, and the newly emerging pandemic becomes a profound health hazard in their cases. This problem further strains the struggling healthcare system, leading to decisions and actions that favor the younger population over the elderly, especially since better outcomes are seen in former compared to the latter. Although many guidelines indicate that the withdrawal of limited resources from severe or terminal patients in order to save the life of others is not an act of killing, such decision causes extreme psychological traumas in the elderly population. The main issue in this regard is not the setting of priorities for receiving treatment, but rather the ambiguity about the implementation of such priorities in terms of morality and continuity as priorities must not deprive individuals of their right to live and survive (especially in vulnerable populations) based on organizational and therapeutic policies.