Open AccessImpact of COVID‐19 Restrictions on Demographics and Outcomes of Patients Undergoing Medically Necessary Non‐Emergent Surgeries During the Pandemic
Author(s) -
Shan Adrienne B.,
Roberson Jeffrey L.,
Keele Luke,
Bharani Tina,
Song Yun,
Miura John T.,
Kelz Rachel R.,
Dempsey Daniel T.,
Fleisher Lee A.,
DeMatteo Ronald P.,
Karakousis Giorgos C.
Publication year - 2021
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/s00268-021-05958-z
Subject(s) - medicine , covid-19 , perioperative , pandemic , cardiac surgery , cardiothoracic surgery , abdominal surgery , vascular surgery , cohort , retrospective cohort study , emergency medicine , surgery , disease , infectious disease (medical specialty)
Background The COVID‐19 pandemic has resulted in large‐scale healthcare restrictions to control viral spread, reducing operating room censuses to include only medically necessary surgeries. The impact of restrictions on which patients undergo surgical procedures and their perioperative outcomes is less understood. Methods Adult patients who underwent medically necessary surgical procedures at our institution during a restricted operative period due to the COVID‐19 pandemic (March 23‐April 24, 2020) were compared to patients undergoing procedures during a similar time period in the pre‐COVID‐19 era (March 25‐April 26, 2019). Cardinal matching and differences in means were utilized to analyze perioperative outcomes. Results 857 patients had surgery in 2019 (pre‐COVID‐19) and 212 patients had surgery in 2020 (COVID‐19). The COVID‐19 era cohort had a higher proportion of patients who were male (61.3% vs. 44.5%, P < 0.0001), were White (83.5% vs. 68.7%, P < 0.001), had private insurance (62.7% vs. 54.3%, p 0.05), were ASA classification 4 (10.9% vs. 3%, P < 0.0001), and underwent oncologic procedures (69.3% vs. 42.7%, P < 0.0001). Following 1:1 cardinal matching, COVID‐19 era patients ( N = 157) had a decreased likelihood of discharge to a nursing facility (risk difference‐8.3, P < 0.0001) and shorter median length of stay (risk difference‐0.6, p 0.04) compared to pre‐COVID‐19 era patients. There was no difference between the two patient cohorts in overall morbidity and 30‐day readmission. Conclusions COVID‐19 restrictions on surgical operations were associated with a change in the racial and insurance demographics in patients undergoing medically necessary surgical procedures but were not associated with worse postoperative morbidity. Further study is necessary to better identify the causes for patient demographic differences.