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Minerva Chirurgica 2020 Nov 11

DOI: 10.23736/S0026-4733.20.08545-4

Copyright © 2020 EDIZIONI MINERVA MEDICA

language: English

Emergency surgery in the time of Coronavirus: the pandemic effect

Jacopo MARTELLUCCI 1 , Andrea DAMIGELLA 1, Carlo BERGAMINI 1, Giovanni ALEMANNO 1, Desiré PANTALONE 1, Andrea CORATTI 1, 2, Paolo MUIESAN 1, 3, Fabio CIANCHI 1, 4, Paolo PROSPERI 1

1 Emergency Surgery Unit, Careggi University Hospital, Florence, Italy; 2 Oncological and Robotic General Surgery, Careggi University Hospital, Florence, Italy; 3 Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy; 4 Digestive Surgery Unit, Department of Clinical and Experimental Medicine, Careggi University Hospital, Florence, Italy


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BACKGROUND: The COVID-19 epidemic became a challenge for Emergency Departments (ED) and a remarkable reduction in surgical emergencies has been widely noticed. Aim of the present study was to evaluate the impact of the pandemic period in the need of surgical emergencies.
METHODS: Between January 1st and May 31st 2020 all the consecutive general surgery emergencies performed by the Careggi University hospital emergency surgery unit were prospectively recorded and compared to the same period of 2019. Demographic and clinical data were recorded and analyzed.
RESULTS: The number of surgical procedures decreased only in the month of March 2020 (compared to 2019), while in April the total numer of emergency surgical procedures was similar. Only appendectomy, complicated hernia repair and colonic resection were significantly reduced (40%, 48% and 33% respectively). The number of small intestine excision, cholecystectomy and lysis of peritoneal adhesions remained stable throughout the entire period. No statistically significant differences were found considering age, sex, Emergency Surgery Score, mortality, ICU postoperative admission and time between admission and surgery, even when analyzed with multivariate analysis for every single surgical procedure, suggesting a comparable disease severity and comorbility patterns. Mortality in COVID patients was 25%, compared to 7% of no-covid patients.
CONCLUSIONS: The COVID pandemic has caused major changes in daily clinical practice, especially in areas such as Emergency. This has led to a temporary reduction and changes in the flow of patients to the emergency room, with implications also for emergency surgical activities.


KEY WORDS: Emergency surgery; COVID; Coronavirus; Pandemic; Appendectomy; Cholecystectomy

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