Open AccessChanges in Emergency General Surgery During Covid‐19 in Scotland: A Prospective Cohort Study
Author(s) -
Dick Lachlan,
Green James,
Brown Jasmine,
Kennedy Ewan,
Cassidy Richard,
Othman Salasiah,
Berlansky Martin
Publication year - 2020
Publication title -
world journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.115
H-Index - 148
eISSN - 1432-2323
pISSN - 0364-2313
DOI - 10.1007/s00268-020-05760-3
Subject(s) - medicine , covid-19 , prospective cohort study , cardiac surgery , vascular surgery , abdominal surgery , cardiothoracic surgery , demographics , cohort , emergency surgery , surgery , emergency medicine , demography , disease , sociology , infectious disease (medical specialty)
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.