Short-term Effects of Canceled Elective Procedures Due to COVID-19: Evidence From the Veterans Affairs Healthcare System.
Ann Surg
; 274(1): 45-49, 2021 07 01.
Article
in English
| MEDLINE | ID: covidwho-1261128
ABSTRACT
OBJECTIVE:
To determine whether delayed or canceled elective procedures due to COVID-19 resulted in higher rates of ED utilization and/or increased mortality. SUMMARY OF BACKGROUND DATA On March 15, 2020, the VA issued a nationwide order to temporarily pause elective cases due to COVID-19. The effects of this disruption on patient outcomes are not yet known.METHODS:
This retrospective cohort study used data from the VA Corporate Data Warehouse. Surgical procedures canceled due to COVID-19 in 2020 (n = 3326) were matched to similar completed procedures in 2018 (n = 151,863) and 2019 (n = 146,582). Outcome measures included 30- and 90-day VA ED use and mortality in the period following the completed or canceled procedure. We used exact matching on surgical procedure category and nearest neighbor matching on patient characteristics, procedure year, and facility.RESULTS:
Patients with elective surgical procedures canceled due to COVID-19 were no more likely to have an ED visit in the 30- [Difference -4.3% pts; 95% confidence interval (CI) -0.078, -0.007] and 90âdays (-0.9% pts; 95% CI -0.068, 0.05) following the expected case date. Patients with cancellations had no difference in 30- (Difference 0.1% pts; 95% CI -0.008, 0.01) and 90-day (Difference -0.4% pts; 95% CI -0.016, 0.009) mortality rates when compared to similar patients with similar procedures that were completed in previous years.CONCLUSIONS:
The pause in elective surgical cases was not associated with short-term adverse outcomes in VA hospitals, suggesting appropriate surgical case triage and management. Further study will be essential to determine if the delayed cases were associated with longer-term effects.
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Veterans
/
Elective Surgical Procedures
/
Emergency Service, Hospital
/
Time-to-Treatment
/
COVID-19
/
Hospitals, Veterans
Type of study:
Cohort study
/
Experimental Studies
/
Observational study
/
Prognostic study
Limits:
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Country/Region as subject:
North America
Language:
English
Journal:
Ann Surg
Year:
2021
Document Type:
Article
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