ABSTRACT
BACKGROUND: The COVID-19 pandemic has had a major impact on healthcare in many countries. This study assessed the effect of a nationwide lockdown in France on admissions for acute surgical conditions and the subsequent impact on postoperative mortality. METHODS: This was an observational analytical study, evaluating data from a national discharge database that collected all discharge reports from any hospital in France. All adult patients admitted through the emergency department and requiring a surgical treatment between 17 March and 11 May 2020, and the equivalent period in 2019 were included. The primary outcome was the change in number of hospital admissions for acute surgical conditions. Mortality was assessed in the matched population, and stratified by region. RESULTS: During the lockdown period, 57 589 consecutive patients were admitted for acute surgical conditions, representing a decrease of 20.9 per cent compared with the 2019 cohort. Significant differences between regions were observed: the decrease was 15.6, 17.2, and 26.8 per cent for low-, intermediate- and high-prevalence regions respectively. The mortality rate was 1.92 per cent during the lockdown period and 1.81 per cent in 2019. In high-prevalence zones, mortality was significantly increased (odds ratio 1.22, 95 per cent c.i. 1.06 to 1.40). CONCLUSION: A marked decrease in hospital admissions for surgical emergencies was observed during the lockdown period, with increased mortality in regions with a higher prevalence of COVID-19 infection. Health authorities should use these findings to preserve quality of care and deliver appropriate messages to the population.
Subject(s)
COVID-19/prevention & control , Patient Admission/statistics & numerical data , Surgical Procedures, Operative/statistics & numerical data , Acute Disease , Adult , Aged , COVID-19/epidemiology , Digestive System Diseases/surgery , Emergencies , Female , France/epidemiology , Humans , Male , Middle Aged , Patient Admission/trends , SARS-CoV-2 , Surgical Procedures, Operative/mortality , Urinary Calculi/surgery , Wounds and Injuries/surgeryABSTRACT
INTRODUCTION: In the last two decades, an impressive increase in the number of surgical interventions was recorded in bariatric surgery. Similarly, several bibliometric studies reported an increasing trend for scientific production. This study aims to compare these two trends. METHODS: This study focused on the period 2003-2016 and included the following procedures: adjustable gastric banding (AGB), bilio-pancreatic deviation (BPD), one-anastomosis gastric bypass (OAGB), Roux-en-Y gastric bypass (RYGB), sleeve gastrectomy (SG), and vertical banded gastroplasty (VBG). We retrieved the data on intervention from International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO) surveys and data from publications from the Web of Science database. An analysis of the global trend and the trend per continent was performed. RESULTS: Over the study period, the most common procedure to be performed was RYGB (47.1%) followed by SG (33.5%) and AGB (14.8%). The percentage of publications was similar, with 48.3% studies on RYGB, 18.5% on AGB, and 18.4% on SG. In terms of evolution, SG has become the most common procedure to be performed in every continent but Latin America, while RYGB remains the most frequently discussed in scientific publications. Asia has the highest rate of publications per 1000 interventions (4.7), followed by Europe (3.0), the Pacific (2.0), and North America (1.6). CONCLUSION: This study found many similarities in the trend of publications and interventions in bariatric surgery: in particular with an important growth rate in the last 15 years and the progressive polarization toward two procedures (SG and RYGB). Nevertheless some important differences persist at a national level.
