The effect of covid-19 pandemic on emergency general surgery cases: A single-center observational study

Abstract

Background/Aim: Many people around the world have been affected by the COVID-19 pandemic. Some of them were directly affected as patients. However, even if some did not suffer from the disease, they may have been indirectly affected. The aim of this study was to investigate whether the COVID-19 pandemic has an impact on emergency general surgery admission volume and operations. Methods: In this retrospective case-control study, all patients referred from the emergency department to our emergency general surgery unit between April 1 - May 31,2020 were evaluated. Patients over 18 years of age, who were hospitalized for longer than 24 hours and required evaluation and treatment by a general surgeon were included in the study. Patients with similar characteristics that were treated in our clinic in the same periods in 2018 and 2019 were evaluated as the control group. Results: During the pandemic, a total of 208 patients were hospitalized in the emergency general surgery service. The number of admissions to the emergency general surgery service in 2020 was 25.9% less than that in 2018 and 30.8% less than that in 2019. During the pandemic, while there was a decrease in cases of non-specific abdominal pain and trauma (P=0.003, P=0.015, respectively), there was a significant increase in cases of gastrointestinal obstruction and perforation (P=0.001, P<0.001, respectively). The rate of surgery during the pandemic was 65.9%, which was significantly higher than the previous years (P<0.001). The rate of laparoscopic procedures decreased significantly during this period (P<0.001). The complication and mortality rates were significantly higher (P=0.004, P=0.025, respectively). Conclusion: We observed that while emergency general surgery case applications, surgery rates, and hospital stay decreased during the COVID-19 pandemic, there was an increase in the rate of more serious diagnoses, complications, and mortality.