Factors affecting 30-day postoperative complications after emergency surgery during the COVID-19 outbreak: A multicentre cohort study

Bock, Ellen de; Filipe, Mando D.; Pronk, Apollo; Boerma, Djamila; Heikens, Joost T.; Verheijen, Paul M.; Vriens, Menno R.; Richir, Milan C.

doi:10.1016/j.ijso.2021.100397

Cited by 3 publications

(3 citation statements)

References 37 publications

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“…It is such, that a trend towards higher numbers of emergency procedures during the SARS-CoV2 pandemic was observed. Comparing the two periods, a 10.2% increase in emergency operations was documented in the pandemic group which can be explained by the above-mentioned increased admission of emergency patients from smaller hospitals and is in line with findings by de Bock et al who reported an increase in the number of emergency surgeries during the COVID-19 outbreak and with Abduljawwad et al who reported no significant change in the prevalence of fusion procedures during the pandemic (7,17).…”

Section: Discussionsupporting

confidence: 87%

The impact of SARS-CoV-2 measures on patient samples and complication rates in spine surgery – A single center analysis

et al. 2023

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ObjectiveOver the past two years during the pandemic, the German health system has taken drastic measures, like the continuous use of face masks for all staff, restrictions of hospital visits as well as cancellation of elective surgical procedures. As a potential side effect of these measures, a significant reduction of surgical site infections was reported for neurosurgical patients. The purpose of our study was to analyze the impact of these measures on spinal surgery.MethodsWe performed a retrospective analysis to compare patient samples, procedures and infection rates before (January 2019 – March 2020) and during (April 2020 – June 2021) the pandemic to evaluate the impact of the measures mentioned above. Demographic and clinical data were collected and correlated with the occurrence of postoperative complications, especially infection.ResultsOur analysis showed no relevant decrease of spine surgeries (838 surgeries in non-pandemic group vs. 831 surgeries pandemic group). The most common postoperative complication was wound infection in both groups, followed by urinary tract infection and pneumonia. In both patient groups, infections were more prevalent in surgeries of multilevel posterior instrumentation. Comparing the two groups of patients, a slight, non-significant (0.5%) reduction of overall postoperative complications in the pandemic group was observed. However, the number of spinal surgeries classified as emergencies in our institution increased by 10.2% during the last 15 months of the COVID-19 pandemic. In line with this finding the urgent transfer of patients from smaller hospitals increased by 14.2%, compared to previous years.ConclusionThe volume of spinal surgeries remained high and complication rates stable during the pandemic. A reason why complication rates did not drop as reported previously might be a significant change in patient sample due to the increase of emergency surgeries. A decrease of complication rates, especially infections by the measures of infection prevention for the pandemic was not observed.

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Section: Discussionsupporting

confidence: 87%

The impact of SARS-CoV-2 measures on patient samples and complication rates in spine surgery – A single center analysis

et al. 2023

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“…Therefore, our results may have been affected by this situation, and the worse outcomes in this group may be associated with worse patients' characteristics. Supporting the idea mentioned above, de Bock et al 16 found that increased age and higher ASA score were independent predictors of postoperative complications after emergency surgery during the outbreak, while the COVID-19 positivity was not. In another study, patients with severe acute respiratory syndrome who underwent elective or emergency surgery were divided into two groups according to the COVID-19 status, and the surgical outcomes were compared.…”

Section: Discussionmentioning

confidence: 73%

The impact of COVID-19 on postoperative outcomes of emergency general surgery operations

Barut,

Bag

2023

KMJ

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Aims: During the pandemic due to Coronavirus disease 2019 (COVID-19) many elective operations were postponed, while emergency surgical operations inevitably continued. Emergency general surgery procedures are known to have worse outcomes compared to elective ones. Besides, it is conceivable that COVID-19 itself may worsen surgical outcomes due to it may cause respiratory distress and multi-organ dysfunction. We aimed to present patients’ data who underwent surgery due to trauma and emergency general surgery diseases during the COVID-19 pandemic and the effect of COVID-19 on surgical outcomes in this study. Methods: Two hundred and thirty-five patients who underwent surgery due to trauma or emergency between March 2020 and January 2021 were enrolled. Two groups were created according to the COVID-19 status as positive (n=16) and negative (n=219). The demographics, clinical, laboratory, and perioperative data were analyzed and compared between these groups. Results: The median age of the patients was 51 (18-97) years, and 144 (61.2%) of them were male. The most common diagnosis was acute appendicitis (n= 121, 51.5%) followed by ileus. Subgroup comparisons showed that the COVID-19 (+) group had more patients with comorbidity and had higher C-reactive protein values, these differences were significant (p= 0.049, p= 0.001, respectively). Open surgery was performed significantly more in the COVID-19 (+) group (p= 0.037). Serious postoperative complications and mortality were seen more in the COVID-19 (+) group, but the differences were not significant. Patients with COVID-19 had significantly longer hospital stay (p= 0.007). Conclusion: COVID-19 positivity was found to have a negative impact on postoperative surgical outcomes in terms of emergency operations. It is not clear whether this negativity is due to the COVID-19 disease itself or the worse characteristics of patients with COVID-19.

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“…We saw that continuing surgery for gastrointestinal diseases can be safe and feasible, as long as strategies recommended by surgical societies to minimize the risk of perioperative SARS-CoV-2 transmission are followed. Data from the Netherlands also described that the performance of emergency general and oncological surgical procedures remained stable in a cohort of 1,399 patients ( 39 ). While data form an international multicenter study recommended to provide COVID-19–free surgical pathways (complete segregation of the operating theater, critical care, and inpatient ward areas) ( 40 ), there was also a study from within the NHS that only found a minimal impact of the pandemic on postoperative morbidity and mortality ( 41 ).…”

Section: Discussionmentioning

confidence: 99%

Delivering Safe Surgical Care While Simultaneously Caring for Patients With COVID-19; Assessment of Patient Selection, Volume and Outcomes in a Tertiary Care Hospital

Domenghino

Staiger²,

Abbassi³

et al. 2023

Int J Public Health

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Objectives: Compare patient selection and postoperative outcomes after surgical treatment for gastrointestinal disorders before and during the SARS-CoV-2 pandemic.Methods: We assessed gastrointestinal surgeries conducted at a tertiary center from 2017–2021 for differences in patient populations and procedures before (up to February 2020) and during the pandemic (March 2020 to December 2021). We analyzed mortality, Intensive Care Unit (ICU) length of stay, admission to ICU and postoperative complications for complex procedures using descriptive statistics and regression models.Results: 7309 procedures were analyzed, showing a caseload reduction in March and October 2020, but no statistical evidence for fewer overall procedures overall. Population characteristics differed with lower Body Mass Indices in 2020 and 2021, more patients smoking and with diabetes treated in 2020. There was no increased mortality, ICU length of stay and in 1,144 complex procedures assessed low overall morbidity at 90 days postoperative.Conclusion: Delivering surgical care while treating patients for COVID-19 in the same hospital was safe. Healthcare officials should consider continuing surgical care during future health crises as consequences of limiting surgical treatment for gastrointestinal disorders may be fatal for patients.

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Factors affecting 30-day postoperative complications after emergency surgery during the COVID-19 outbreak: A multicentre cohort study

Cited by 3 publications

References 37 publications

The impact of SARS-CoV-2 measures on patient samples and complication rates in spine surgery – A single center analysis

The impact of SARS-CoV-2 measures on patient samples and complication rates in spine surgery – A single center analysis

The impact of COVID-19 on postoperative outcomes of emergency general surgery operations

Delivering Safe Surgical Care While Simultaneously Caring for Patients With COVID-19; Assessment of Patient Selection, Volume and Outcomes in a Tertiary Care Hospital

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