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The impact of the COVID-19 pandemic on acute surgical care
EAES Academy. Simonka Z. 07/05/22; 363100; P145
Zsolt Simonka
Zsolt Simonka
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Abstract
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Introduction:

The coronavirus pandemic has fundamentally changed the healthcare system. At the highest peak in Hungary when restrictions were put into place for 146 days in which planned surgeries for benign diseases were also restricted. Our assumption was that this event affecting two fifths of the year of 2020 could lead to an increase in the number of emergency cases.

Patients and Method: We compared the surgical distribution in one year from before the pandemic (2019) and during the pandemic (2020) at the Department of Surgery, University of Szeged. The number of emergency appendectomies, cholecystectomies and hernias were analysed.

Results:

In 2019, 212 appendectomies were performed whilst in 2020 it was 181. This represents a 15% reduction in expected appendectomies. In 2019, out of the 676 cholecystectomies, 52 were acute cases. Due to the restrictions in 2020, the number of cholecystectomies reduced to 422 surgeries, of which 40 were emergency cases. There was a 38% reduction in all cholecystectomy surgeries and the emergency surgical cases only showed a 23% decrease. In 2019, there were 536 hernia surgeries, of which 82 were emergency cases. In 2020, there was a decrease in the hernia surgeries to 429, of which 54 cases were acute cases. The hernia surgical cases decreased by 20% in the year of 2020. However, the number of emergency surgeries (incarcerated hernia cases) fell by 34%.

Conclusion:
Contrary to our assumption, the number of appendectomies which represented a standard emergency surgical care decreased by almost the same proportion as the total number of surgeries. The number of planned cholecystectomies and hernia surgeries decreased by 39% and 17% respectively, but this did not lead to an increase in the number of emergency cholecystectomies and hernia surgeries, paradoxically the number of which also decreased. This can only be partially explained by the possibility of conservative treatment and the change in indication for surgery. Further investigations are needed to clarify other causes.
Introduction:

The coronavirus pandemic has fundamentally changed the healthcare system. At the highest peak in Hungary when restrictions were put into place for 146 days in which planned surgeries for benign diseases were also restricted. Our assumption was that this event affecting two fifths of the year of 2020 could lead to an increase in the number of emergency cases.

Patients and Method: We compared the surgical distribution in one year from before the pandemic (2019) and during the pandemic (2020) at the Department of Surgery, University of Szeged. The number of emergency appendectomies, cholecystectomies and hernias were analysed.

Results:

In 2019, 212 appendectomies were performed whilst in 2020 it was 181. This represents a 15% reduction in expected appendectomies. In 2019, out of the 676 cholecystectomies, 52 were acute cases. Due to the restrictions in 2020, the number of cholecystectomies reduced to 422 surgeries, of which 40 were emergency cases. There was a 38% reduction in all cholecystectomy surgeries and the emergency surgical cases only showed a 23% decrease. In 2019, there were 536 hernia surgeries, of which 82 were emergency cases. In 2020, there was a decrease in the hernia surgeries to 429, of which 54 cases were acute cases. The hernia surgical cases decreased by 20% in the year of 2020. However, the number of emergency surgeries (incarcerated hernia cases) fell by 34%.

Conclusion:
Contrary to our assumption, the number of appendectomies which represented a standard emergency surgical care decreased by almost the same proportion as the total number of surgeries. The number of planned cholecystectomies and hernia surgeries decreased by 39% and 17% respectively, but this did not lead to an increase in the number of emergency cholecystectomies and hernia surgeries, paradoxically the number of which also decreased. This can only be partially explained by the possibility of conservative treatment and the change in indication for surgery. Further investigations are needed to clarify other causes.
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