The volume of general surgery emergency cases in a government hospital during the COVID-19 pandemic and two other periods: a comparative, retrospective study

Shakra, Ibrahim Abu; Bez, Maxim; Ganam, Samer; Francis, Rola; Muati, Amir; Bickel, Amitai; Merei, Fahed; Talmi, Ziv; Kamal, Khatib; Kakiashvili, Eli

doi:10.1186/s12893-021-01131-4

Cited by 4 publications

(5 citation statements)

References 16 publications

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“…A possible reason could be that patients, most likely for fear of contracting COVID-19, avoided attending hospitals until their condition did not allow them to defer it any longer. This match reports from other hospitals, especially in relation to emergency surgical cases [ 23 , 24 ] or the need for higher-level transfers [ 16 ].…”

Section: Discussionsupporting

confidence: 70%

Emergencies in the COVID-19 Era: Less Attendances, More Admissions

Fyntanidou¹,

Stavrou²,

Apostolopoulou³

et al. 2022

Cureus

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Introduction Healthcare systems suffered a significant hit by the COVID-19 pandemic since the spring of 2020, and a need for major reorganization emerged. Along with the constant increase in COVID-19 cases, a significant drop in emergency attendances for non-COVID-19-related conditions was noted worldwide. We decided to document attendances in our hospital's emergency department during the first lockdown period in order to monitor this trend, compare it to data from other countries, and start monitoring the effects of this reduction in the years to come. Materials and methods Emergency department attendances at AHEPA University Hospital, Thessaloniki, Greece, from March 10, 2020, to May 31, 2020, were documented and compared to the corresponding period in 2019. The data collected included the number of patients per specialty, severity upon admission, as well as the need for admission. Results We found a 58% reduction in emergency department attendance during the studied period compared to the corresponding period in 2019 (p<0.0001). The reduction was more noticeable in ears, nose, throat (ENT), and ophthalmology attendances (75.7% and 78.1% reductions, respectively, p<0.001), but other specialties, such as cardiology and general surgery, were also significantly affected (60% and 63% reductions, respectively, p<0.001). However, the percentage of attendances that required admission increased significantly by 25-33% (p<0.001) during the lockdown, reflecting the higher severity of cases reaching the hospital. Conclusion Despite the obvious reduction in attendances during the COVID-19 pandemic, patients still suffer from serious conditions that require hospital admission. Therefore, hospitals need to be supported to also care for these patients. The long-term effects of avoiding hospital attendance need to be closely monitored.

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Section: Discussionsupporting

confidence: 70%

Emergencies in the COVID-19 Era: Less Attendances, More Admissions

Fyntanidou¹,

Stavrou²,

Apostolopoulou³

et al. 2022

Cureus

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“…Although postponing elective hernia operations during the pandemic has raised concerns that the number of EAAWHS may increase due to incarceration or strangulation, recent studies have reported a decrease in the number of patients [ 21 , 22 ]. In our study, 41 patients were operated emergently during the pandemic, while 24 patients were operated during the control period.…”

Section: Discussionmentioning

confidence: 99%

“…In short-term studies with a low number of EAAWHS cases, it was reported that EAAWHS was decreased during the pandemic period compared to the control period. [ 21 , 22 ]. Oscar Cano-Valderemma et al reported a decrease in the number of general surgery emergency groups but an increased number of incarcerated hernia cases [ 15 ].…”

Section: Discussionmentioning

confidence: 99%

The effects of COVID-19 pandemic on emergency anterior abdominal wall hernia surgery: is it safe to postpone elective hernia surgery in the pandemic?

Turan

Dirim

2021

Eur J Trauma Emerg Surg

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Background The aim of this study was to investigate the effects of the COVID-19 pandemic on emergency anterior abdominal wall hernia surgeries (EAAWHS) by comparing the pandemic period with the control period a year ago and to share our experiences in the pandemic period. Methods This single-center retrospective cohort study included all patients who underwent EAAWHS during the pandemic (from 11 March 2020 to 25 January 2021) and control period (1 year before the same period, from 11 March 2019 to 25 January 2020). Demographic data, preoperative clinical and pathological parameters, intraoperative findings and postoperative complications secondary to operation and COVID-19 infection, length of intensive care and hospital stay of patients were recorded, and the pandemic and control groups were compared. Results Of the 87 patients who underwent anterior abdominal wall hernia surgery during the COVID-19 pandemic, 41 (47.1%) were operated emergently and 46 (52.9%) were operated electively. Of the 485 patients who underwent anterior abdominal wall hernia surgery during the control period, 24 (4.95%) were operated emergently and 461 (95.05%) were operated electively. The decrease in the number of elective operations and the increase in the number of emergency operations were significant during the pandemic ( p < 0.001).There was a decrease in the number of emergency inguinal hernia operations and an increase in the number of emergency ventral (incisional, umbilical) hernia operations during the pandemic period compared to the control period ( p < 0.05).The mortality rates were similar (8.3 vs. 9.8%, p > 0.05) in both periods. Conclusion Despite the increase in the number of EAAWHS during the COVID-19 pandemic, there was no significant difference in mortality and morbidity rates. EAAWHS can be performed safely during the pandemic by taken necessary and adequate precautions.

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“…Almost all studies showed that WW delays, but does not remove the need for surgical treatment of inguinal hernia, while the risk of complications in case of watchful waiting WW is low and the risk of chronic pain after hernia surgery remains high. A current consideration is that the COVID‐19 pandemic 43 may have increased surgeons' 44–46 and patients' 47 interest for WW, as well as the reduced opportunity for elective inguinal hernia repairs performed, 48 providing more future data, but no definitive conclusion can be drawn up to now.…”

Section: Discussionmentioning

confidence: 99%

Asymptomatic inguinal hernia: does it need surgical repair? A systematic review and meta‐analysis

Cirocchi

Burini

Avenia

et al. 2022

ANZ Journal of Surgery

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Background: The aim of this review is to compare the outcomes of surgical repair versus watchful waiting in asymptomatic or minimally symptomatic inguinal hernias. Methods: Preferred reporting items for systematic reviews and meta-analyses guidelines were employed. We analysed primary outcomes: pain, quality of life, pain during daily activities and visual analogue scale (VAS that measures pain at rest and on movement) and secondary outcomes: postoperative complications and recurrence. Results: Pain and quality of life were not comparable due to differences in the parameters used in different articles. Pain interfering with normal daily activity was evaluated in one study and appears more favourable in the post-repair group respect to the watchful waiting (WW) group (5.1% versus 2.2%). VAS, measured in one study, at 6 months was more favourable in the surgery group (37% versus 44%). After 12 months the outcome was better in the control group than in the repair group (28% versus 30%). Conversion rate of the patient cohorts from watchful waiting to elective surgery was between 35.03% and 57.8%. The meta-analysis did not find significant statistical differences in the two groups examined for postoperative complications [RR = 0.95, 95% CI (0.50, 1.80), P = 0.88], as for hernia recurrence [RR = 1.01, 95% CI (0.50, 2.02), P = 0.98]. Conclusion: WW seems to be an acceptable option for the patient with asymptomatic or minimally symptomatic inguinal hernias. Delaying surgical repair until symptoms appear is safe. Acute hernia incarcerations are not particularly frequent. The incidence of chronic pain after the repair is high. Physicians must select patients carefully and explain to them the risks and benefits of surgery.

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The volume of general surgery emergency cases in a government hospital during the COVID-19 pandemic and two other periods: a comparative, retrospective study

Cited by 4 publications

References 16 publications

Emergencies in the COVID-19 Era: Less Attendances, More Admissions

Emergencies in the COVID-19 Era: Less Attendances, More Admissions

The effects of COVID-19 pandemic on emergency anterior abdominal wall hernia surgery: is it safe to postpone elective hernia surgery in the pandemic?

Asymptomatic inguinal hernia: does it need surgical repair? A systematic review and meta‐analysis

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