Impact of COVID-19 on Emergency General Surgery

Abstract

Background There are limited data on emergency surgical practice during the covid-19 era. Objectives To evaluate the outcomes for emergency surgery before and during Covid-19. Methods This is a retrospective study of emergency admissions to one general surgery department during November 2019 (which is likely to represent our normal working pattern) and April 2020 (which was the peak of the Covid-19 crisis in our population). Data of each of these 2 months were collected separately. Patients demographic features, type of procedures, blood test results, procedure approach( open, laparoscopic), morbidities and mortality were reported. Statistical analysis using descriptive statistics, Chi-square, and Z -tests were used for statistical significance analysis value taken as The primary endpoints were Covid-19 diagnosis, the number and types of surgical admissions and procedures. The secondary endpoints were complications, mortality, laparoscopic and open approaches,CRP and white cell count, length of stay, age and gender. Results: 332 patients were admitted [146 patients during April 2020, and 177 patients during November 2019. There were 147 male and 176 female. The mean age was 51 year for November group and 49 years for April group. There were 146 procedures performed during November while 117 operations were conducted during April. Length of stay was 5.87 and 5.43 for November and April patients respectively. There were 7 patients tested +ve for Covid-19 and 3 mortality in each group. Acute cholecystitis, abscess, diverticulitis and CRP are showing significant differences between the two groups, P-value Conclusions The postoperative complications, mortality and acute cholecystitis are significantly higher while abscess and diverticulitis are significantly reduced