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Emergency surgery admissions and the COVID-19 pandemic: did the first wave really change our practice? Results of an ACOI/WSES international retrospective cohort audit on 6263 patients

2022; BioMed Central; Volume: 17; Issue: 1 Linguagem: Inglês

10.1186/s13017-022-00407-1

1749-7922

Giovanni Domenico Tebala, Marika S. Milani, Mark Bignell, Giles Bond‐Smith, Christopher Lewis, Roberto Cirocchi, Salomone Di Saverio, Fausto Catena, Marco Scatizzi, Pierluigi Marini, Réa Lo Dico, A Stracqualursi, Giuseppe Russo, Sara D’Errico, Pasquale Cianci, Enrico Restini, G. Scialandrone, Gianluca Guercioni, Gennaro Martinez, Angela Pezzolla, Donato F. Altomare, Arcangelo Picciariello, Giuseppe Trigiante, Rigers Dibra, Vincenzo Papagni, C. Righetti, Roberto Polastri, Jacopo Andreuccetti, Giusto Pignata, Rossella D’Alessio, Elisa Arici, Ilaria Canfora, Nicola Cillara, Antonello Deserra, Raffaele Sechi, Francesco Bianco, Simona Gili, Antonio Cappiello, Paola Incollingo, Alan Biloslavo, Gabriele Bellio, Paola Germani, Nicolò de Manzini, Marco Buiatti, Fabio P. Paladino, Diego Sasia, Felice Borghi, Valentina Testa, Giorgio Giraudo, Fabrizio Allisiardi, Maria Carmela Giuffrida, Martino Gerosa, Alessandro Fogliati, Dario Maggioni, Nicolò Fabbri, Carlo V. Feo, Erica Bianchini, Ilaria Panzini, Vincenzo Lizzi, Fausto Tricarico, Giovanni Di Gioia, Rocco Melino, Nicola Tartaglia, Antonio Ambrosi, Giovanna Pavone, Mario Pacilli, Fernanda Vovola, Fiorenza Belli, Andrea Barberis, Antonio Azzinnaro, Andrea Coratti, Roberto Benigni, Stefano Berti, Michele Saracco, Andrea Gennai, Laura Dova, Roberto Farfaglia, Giacomo Pata, Valeria Arizzi, G Pandolfo, Alice Frontali, Piergiorgio Danelli, Luca Ferrario, Claudio Guerci, Nicolò Maria Mariani, Andrea Pisani Ceretti, Vincenzo Nicastro, Enrico Opocher, Davide Gozzo, Gianmaria Casoni Pattacini, Maurizio Castriconi, Alfonso Amendola, Maria Gaudiello, Giuseppe Palomba, Fausto Catena, Gabriele Luciano Petracca, Gennaro Perrone, Mario Giuffrida, Gianluigi Moretto, Harmony Impellizzeri, Andrea Casaril, Mauro Filosa, Antonio Caizzone, Sonia Agrusti, G Cattaneo, P. Capelli, Andrea Muratore, Marcello Calabrò, Nicoletta S. Pipitore Federico, Bruno Cuzzola, Riccardo Danna, Alessandra Murgese, Federico Coccolini, Erica Pieroni, Massimo Chiarugi, Dario Tartaglia, Sandro Giannessi, Riccardo Somigli, Martina Trafeli, Massimo Fedi, R De Vincenti, Anna Guariniello, Michele Grande, Giulia Bagaglini, Brunella Maria Pirozzi, Andrea Martina Guida, Sara Ingallinella, Cristine Pathirannehalage Don, Leandro Siragusa, Orazio CAPONE, Daniele Cerbo, Emanuele Santoro, Vito Pende, Alessia Fassari, Andrea Mingoli, Gioia Brachini, Bruno Cirillo, Martina Zambon, Pierfranco Maria Cicerchia, Simona Meneghini, Paolo Sapienza, Antonella Puzzovio, Filippo La Torre, Pietro Fransvea, Marta Di Grezia, Gabriele Sganga, Mariano Fortunato Armellino, Giovanna Ioia, Bernardino Rampone, Marcello Della Corte, Francesco Fleres, Guglielmo Clarizia, Pierpaolo Bordoni, Alessandro Spolini, Marco Franzini, A Grechi, Monica Suppo, Dario Bono, Donatella Scaglione, Christian Cotsoglou, Sissi Paleini, Andréa Chierici, Matteo Uccelli, Stefano Olmi, G Cesana, Nádia Tenreiro, A. Marçal, Daniela Martins, Clara Leal, Bruno Vieira, Bakarne Ugarte-Sierra, Irune Vincene-Rodriguez, Marta Duran-Ballesteros, Amaia Sanz-Larrainzar, F J Ibáñez-Aguirre, Carlos Yanez-Benites, Issa Talal, Juan Luís Blas, Roberta Garau, Saskia Clark-Stuart, Angus Wallace, Andrew Di Carlo, Ellen Wisnia, Konain Ehsan, Kellen Beck-Sanders, Emma Godson, Paul Campbell, Giovanni Domenico Tebala, Mark Bignell, Giles Bond‐Smith, Christopher Lewis, Raheel Ahmad, Roshneen Ali, Sambasivan S. Aswani, Barza Afzal, Catalina Carrillo, Aruna Dawani, Abishek Dey, Amr Elserafy, Diana Ruth Farias Araujo Gaspar, Lucia Lazzareschi, Mitul Patel, Amanda Shabana, Mohamed Shams, Ola Shams, Zoe Slack,

Appendicitis Diagnosis and Management

The COVID-19 pandemic is having a deep impact on emergency surgical services, with a significant reduction of patients admitted into emergency surgical units world widely. Reliable figures of this reduction have not been produced yet. Our international audit aimed at giving a precise snapshot of the absolute and relative changes of emergency surgical admissions at the outbreak of the pandemic.Datasets of patients admitted as general surgical emergencies into 45 internationally distributed emergency surgical units during the months of March and April 2020 (Covid-19 pandemic outbreak) were collected and compared with those of patients admitted into the same units during the months of March and April 2019 (pre-Covid-19). Primary endpoint was to evaluate the relative variation of the presentation symptoms and discharge diagnoses between the two study periods. Secondary endpoint was to identify the possible change of therapeutic strategy during the same two periods.Forty-five centres participated sent their anonymised data to the study hub, for a total of 6263 patients. Of these, 3810 were admitted in the pre-Covid period and 2453 in the Covid period, for a 35.6% absolute reduction. The most common presentation was abdominal pain, whose incidence did not change between the two periods, but in the Covid period patients presented less frequently with anal pain, hernias, anaemia and weight loss. ASA 1 and low frailty patients were admitted less frequently, while ASA>1 and frail patients showed a relative increase. The type of surgical access did not change significantly, but lap-to-open conversion rate halved between the two study periods. Discharge diagnoses of appendicitis and diverticulitis reduced significantly, while bowel ischaemia and perianal ailments had a significant relative increase.Our audit demonstrates a significant overall reduction of emergency surgery admissions at the outbreak of the Covid-19 pandemic with a minimal change of the proportions of single presentations, diagnoses and treatments. These findings may open the door to new ways of managing surgical emergencies without engulfing the already busy hospitals.