Frequency and severity of general surgical emergencies during the COVID-19 pandemic: single-centre experience from a large metropolitan teaching hospital

• Published in: Annals of the Royal College of Surgeons of England Vol. 102; no. 6; pp. 1 - 462
• Main Authors: Patel, R, Hainsworth, A J, Devlin, K, Patel, J H, Karim, A
• Format: Journal Article
• Language: English
• Published: England BMJ Publishing Group LTD 01.07.2020; Royal College of Surgeons
• Subjects: Abdomen; Age; Antibiotics; Archives & records; Blood; Coronaviruses; COVID-19; Disease transmission; Emergency Care; Hospitals; Laparoscopy; Pandemics; Patients; Surgery; Trauma; Ultrasonic imaging; Vital signs; China; COVID-19; Coronavirus; Pandemic; Emergency service; General surgery
• ISSN: 0035-8843; 1478-7083
• DOI: 10.1308/rcsann.2020.0147

The COVID-19 pandemic has put significant stress on healthcare systems globally. This study focuses on emergency general surgery services at a major trauma centre and teaching hospital. We aimed to identify whether the number of patients and the severity of their presentation has significantly changed since the implementation of a national lockdown. This study is a retrospective review of acute referrals (from general practice and accident and emergency) to the emergency general surgery team over a 14-day period before (group 1) and during (group 2) lockdown. A total of 151 patients were reviewed by the general surgical team in group 1 and 75 in group 2 (a 50.3% reduction). The number of days with symptoms prior to presentation was significantly shorter in group 1 compared with group 2 (3 vs 4, = 0.04). There was no significant difference in the National Early Warning Score, white blood cell count, lymphocytes and C-reactive protein on admission between the two groups of patients. There were significantly fewer patients admitted after lockdown compared with pre-lockdown (66% vs 48%, = 0.01). Length of hospital stay was significantly shorter during lockdown compared with pre-lockdown (5 days vs 4 days, = 0.04). Fewer patients were referred and admitted during lockdown compared with pre-lockdown, and the length of stay was also significantly reduced. There was also a delay in presentation to hospital, although these patients were not more unwell based on the scoring criteria used within this study.