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Association between COVID-19 related elective surgery cancellations and pediatric inguinal hernia complications: A nationwide multicenter cohort study.
Hu, Andrew; Reiter, Audra J; Gerardo, Rodrigo; Skertich, Nicholas J; Lewit, Ruth; Ghani, Muhammad; Witte, Amanda; Kang, Hae-Sung; Richards, Holden; Perry, Bradley; Tian, Yao; Mehl, Steven C; Gonzalez, Andres; Novotny, Nathan M; Haynes, Jeffrey; Aranda, Arturo; Zamora, Irving J; Rhee, Daniel; Fialkowski, Elizabeth; Slater, Bethany J; Van Arendonk, Kyle; Gosain, Ankush; Lopez, Monica E; Raval, Mehul V.
  • Hu A; Division of Pediatric Surgery, Department of Surgery, Northwestern University Feinberg School of Medicine, Ann & Robert H. Lurie Children's Hospital of Chicago, IL. Electronic address: ahu1@northwestern.edu.
  • Reiter AJ; Division of Pediatric Surgery, Department of Surgery, Northwestern University Feinberg School of Medicine, Ann & Robert H. Lurie Children's Hospital of Chicago, IL.
  • Gerardo R; Division of Pediatric Surgery, Wright State University, Dayton Children's Hospital, OH.
  • Skertich NJ; Division of Pediatric Surgery, Rush University, Children's Hospital in Chicago, IL.
  • Lewit R; Division of Pediatric Surgery, Department of Surgery, University of Tennessee Health Science Center, Le Bonheur Children's Hospital, Memphis, TN.
  • Ghani M; Department of Pediatric Surgery, Vanderbilt University Medical Center, Vanderbilt Children's Hospital, Nashville, TN.
  • Witte A; Division of Pediatric Surgery, Medical College of Wisconsin, Children's Wisconsin, Milwaukee, WI.
  • Kang HS; Department of Pediatric Surgery, Virginia Commonwealth University, Children's Hospital of Richmond, VA.
  • Richards H; Department of Pediatric Surgery, Oregon Health and Science University, Doernbecher Children's Hospital, Portland, OR.
  • Perry B; Division of Pediatric Surgery, Beaumont Children's Hospital, Royal Oak, MI.
  • Tian Y; Division of Pediatric Surgery, Department of Surgery, Northwestern University Feinberg School of Medicine, Ann & Robert H. Lurie Children's Hospital of Chicago, IL.
  • Mehl SC; Department of Pediatric Surgery, Baylor College of Medicine, Texas Children's Hospital, Houston, TX.
  • Gonzalez A; Department of Pediatric Surgery, Johns Hopkins Medicine, Johns Hopkins Children's Center, Baltimore, MD.
  • Novotny NM; Division of Pediatric Surgery, Beaumont Children's Hospital, Royal Oak, MI.
  • Haynes J; Department of Pediatric Surgery, Virginia Commonwealth University, Children's Hospital of Richmond, VA.
  • Aranda A; Division of Pediatric Surgery, Wright State University, Dayton Children's Hospital, OH.
  • Zamora IJ; Department of Pediatric Surgery, Vanderbilt University Medical Center, Vanderbilt Children's Hospital, Nashville, TN.
  • Rhee D; Department of Pediatric Surgery, Johns Hopkins Medicine, Johns Hopkins Children's Center, Baltimore, MD.
  • Fialkowski E; Department of Pediatric Surgery, Oregon Health and Science University, Doernbecher Children's Hospital, Portland, OR.
  • Slater BJ; Department of Pediatric Surgery, University of Chicago Medicine, Comer Children's Hospital, Chicago, IL.
  • Van Arendonk K; Division of Pediatric Surgery, Medical College of Wisconsin, Children's Wisconsin, Milwaukee, WI.
  • Gosain A; Division of Pediatric Surgery, Department of Surgery, University of Tennessee Health Science Center, Le Bonheur Children's Hospital, Memphis, TN.
  • Lopez ME; Department of Pediatric Surgery, Vanderbilt University Medical Center, Vanderbilt Children's Hospital, Nashville, TN.
  • Raval MV; Division of Pediatric Surgery, Department of Surgery, Northwestern University Feinberg School of Medicine, Ann & Robert H. Lurie Children's Hospital of Chicago, IL.
Surgery ; 172(3): 989-996, 2022 09.
Article in English | MEDLINE | ID: covidwho-1852108
ABSTRACT

BACKGROUND:

Optimal inguinal hernia repair timing remains controversial. It remains unclear how COVID-19 related elective surgery cancellations impacted timing of inguinal hernia repair and whether any delays led to complications. This study aims to determine whether elective surgery cancellations are safe in pediatric inguinal hernia.

METHODS:

This multicenter retrospective cohort study at 14 children's hospitals included patients ≤18 years who underwent inguinal hernia repair between September 13, 2019, through September 13, 2020. Patients were categorized by whether their inguinal hernia repair occurred before or after their hospital's COVID-19 elective surgery cancellation date. Incarceration and emergency department encounters were compared between pre and postcancellation.

RESULTS:

Of 1,404 patients, 604 (43.0%) underwent inguinal hernia repair during the postcancellation period, 92 (6.6%) experienced incarceration, and 213 (15.2%) had an emergency department encounter. The postcancellation period was not associated with incarceration (odds ratio 1.54; 95% confidence interval 0.88-2.71; P = .13) or emergency department encounters (odds ratio 1.53; 95% confidence interval 0.94-2.48; P = .09) despite longer median times to inguinal hernia repair (precancellation 29 days [interquartile range 13-55 days] versus postcancellation 31 days [interquartile range 14-73 days], P = .01). Infants were more likely to have the emergency department be their index presentation in the postcancellation period (odds ratio 1.69; 95% confidence interval 1.24-2.31; P < .01).

CONCLUSION:

Overall, COVID-19 elective surgery cancellations do not appear to increase the likelihood of incarceration or emergency department encounters despite delays in inguinal hernia repair, suggesting that cancellations are safe in children with inguinal hernia. Assessment of elective surgery cancellation safety has important implications for health policy.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 / Hernia, Inguinal Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study Topics: Long Covid Limits: Child / Humans / Infant Language: English Journal: Surgery Year: 2022 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 / Hernia, Inguinal Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study Topics: Long Covid Limits: Child / Humans / Infant Language: English Journal: Surgery Year: 2022 Document Type: Article