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Changes in Emergency General Surgery During Covid-19 in Scotland: A Prospective Cohort Study.
Dick, Lachlan; Green, James; Brown, Jasmine; Kennedy, Ewan; Cassidy, Richard; Othman, Salasiah; Berlansky, Martin.
  • Dick L; Department of General Surgery, Borders General Hospital, Melrose, TD6 9BS, UK. lachlandick@nhs.net.
  • Green J; Department of General Surgery, Borders General Hospital, Melrose, TD6 9BS, UK.
  • Brown J; Department of General Surgery, Borders General Hospital, Melrose, TD6 9BS, UK.
  • Kennedy E; Department of General Surgery, Borders General Hospital, Melrose, TD6 9BS, UK.
  • Cassidy R; Department of General Surgery, Borders General Hospital, Melrose, TD6 9BS, UK.
  • Othman S; Department of General Surgery, Borders General Hospital, Melrose, TD6 9BS, UK.
  • Berlansky M; Department of General Surgery, Borders General Hospital, Melrose, TD6 9BS, UK.
World J Surg ; 44(11): 3590-3594, 2020 11.
Article in English | MEDLINE | ID: covidwho-734107
ABSTRACT

INTRODUCTION:

Covid-19 has had a significant impact on all aspects of health care. We aimed to characterise the trends in emergency general surgery at a district general hospital in Scotland.

METHODS:

A prospective cohort study was performed from 23/03/20 to 07/05/20. All emergency general surgery patients were included. Demographics, diagnosis and management were recorded along with Covid-19 testing and results. Thirty-day mortality and readmission rates were also noted. Similar data were collected on patients admitted during the same period in 2019 to allow for comparison.

RESULTS:

A total of 294 patients were included. There was a 58.3 per cent reduction in admissions when comparing 2020 with 2019 (85 vs 209); however, there was no difference in age (53.2 vs 57.2 years, p = 0.169) or length of stay (4.8 vs 3.7 days, p = 0.133). During 2020, the diagnosis of appendicitis increased (4.3 vs 18.8 per cent, p = < 0.05) as did severity (0 per cent > grade 1 vs 58.3 per cent > grade 1, p = < 0.05). The proportion of patients undergoing surgery increased (19.1 vs 42.3 per cent, p = < 0.05) as did the mean operating time (102.4 vs 145.7 min, p = < 0.05). Surgery was performed in 1 confirmed and 1 suspected Covid-19 patient. The latter died within 30 days. There were no 30-day readmissions with Covid-19 symptoms.

CONCLUSION:

Covid-19 has significantly impacted the number of admissions to emergency general surgery. However, emergency operating continues to be needed at pre-Covid-19 levels and as such provisions need to be made to facilitate this.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Main subject: Patient Admission / Pneumonia, Viral / General Surgery / Surgical Procedures, Operative / Practice Patterns, Physicians&apos; / Coronavirus Infections / Pandemics / Betacoronavirus Type of study: Cohort study / Diagnostic study / Observational study / Prognostic study Limits: Adult / Aged / Female / Humans / Male / Middle aged Country/Region as subject: Europa Language: English Journal: World J Surg Year: 2020 Document Type: Article Affiliation country: S00268-020-05760-3

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Patient Admission / Pneumonia, Viral / General Surgery / Surgical Procedures, Operative / Practice Patterns, Physicians&apos; / Coronavirus Infections / Pandemics / Betacoronavirus Type of study: Cohort study / Diagnostic study / Observational study / Prognostic study Limits: Adult / Aged / Female / Humans / Male / Middle aged Country/Region as subject: Europa Language: English Journal: World J Surg Year: 2020 Document Type: Article Affiliation country: S00268-020-05760-3