Impact of Coronavirus Disease (Covid-19) Pandemic and Lockdown Over the Pattern of Hospitalisation, Surgical Burden and Changes in the Surgical Practices

ABSTRACT

Objective: To quantify the impact of Coronavirus disease (COVID-19) pandemic and lockdown over the pattern of hospitalisation surgical burden and changes in the surgical practices of patients at department of General Surgery, MY Hospital, Indore. Methods: Data pertaining to the hospital admission in department of surgery, MY Hospital, Indore during the period of 25th March till 14th April 2019 and between January 1, 2020 to June 30, 2020 was collected and evaluated for multiple parameters like the duration and cause of admission in the hospital, treatment offered and outcomes. This data was thoroughly assessed and looked for the differences in monthly hospitalisation, disease specific hospitalisation rate, mortality status and other parameters during precovid, covid and post covid era. Results: During covid phase, discharge percentage decreased from 74.70 % to 39.47 %, the LAMA percentage rose from 12.47 % to 31.58 % and death percentage increased from 12.65 % to 27.63 %. The emergency admissions were the major indications for admission during both the phases, however elective admissions fell from 233 (39.89 %) in the non-lockdown phase (2019) to 0 in the lockdown phase (2020). The percentage of non-referred patients increased during the lockdown phase (2020). The difference between the two groups was not found to be statistically significant. Overall conservative management was the most commonly followed approach in both the phases. The percentage of conservative management increased from 42.90 % during the Non-Lockdown phase (2019) to 73.68 % during the lockdown phase. All surgeries performed during the Lockdown 01 Phase were emergency surgeries. Conclusion: The other changes in the surgical practices within the Department of Surgery included significant decrease in the number of elective admissions and elective surgeries, increased preference for conservative management over surgical management, increased preference for regional anaesthesia, a decreased mean duration of stay for a patient in the hospital. Changes noted in surgical practices also included significantly reduced number of laparoscopic procedures. These changes appear to be a response towards the COVID 19 pandemic to prevent the spread of infection within the hospital as well as an attempt to secure the healthcare resources for the mitigation of ongoing COVID 19 pandemic.