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Impact of the SARS-CoV-2 pandemic on emergency surgery services-a multi-national survey among WSES members.
World J Emerg Surg. 2020 12 09; 15(1):64.WJ

Abstract

BACKGROUND

The SARS-CoV-2 pandemic is a major challenge for health care services worldwide. It's impact on oncologic therapies and elective surgery has been described recently, and the literature provides guidelines regarding appropriate elective patient treatment during the pandemic. However, the impact of SARS-CoV-2 pandemic on emergency surgery services has been poorly investigated up to now.

METHODS

A 17-item web survey had been distributed to emergency surgeons in June 2020 around the world, investigating the impact of SARS-CoV-2 pandemic on patients and septic diseases both requiring emergency surgery and the time-to-intervention in emergency surgery routine, as well as experiences with surgery in COVID-19 patients.

RESULTS

Ninety-eight collaborators from 31 countries responded to the survey. The majority (65.3%) estimated the impact of the SARS-CoV-2 pandemic on emergency surgical patient care as being strong or very strong. Due to the pandemic, 87.8% reported a decrease in the total number of patients undergoing emergency surgery and approximately 25% estimated a delay of more than 2 h in the time-to-diagnosis and another 2 h in the time-to-intervention. Fifty percent make structural problems with in-hospital logistics (e.g. transport of patients, closed normal wards etc.) mainly responsible for delayed emergency surgery and the frequent need (56.1%) for a triage of emergency surgical patients. 56.1% of the collaborators observed more severe septic abdominal diseases during the pandemic, especially for perforated appendicitis and severe septic cholecystitis (41.8% and 40.2%, respectively). 62.2% had experiences with surgery in COVID-19-infected patients.

CONCLUSIONS

The results of The WSES COVID-19 emergency surgery survey are alarming. The combination of an estimated decrease in numbers of emergency surgical patients and an observed increase in more severe septic diseases may be a result of the fear of patients from infection with COVID-19 and a consecutive delayed hospital admission and diagnosis. A critical delay in time-to-diagnosis and time-to-intervention may be a result of changes in in-hospital logistics and operating room as well as intensive care capacities. Both reflect the potentially harmful impact of SARS-CoV-2 pandemic on emergency surgery services.

Authors+Show Affiliations

Department of General, Visceral, Thoracic, Transplant and Pediatric Surgery, University Hospital of Giessen, Giessen, Germany.Department of Surgery, Macerata Hospital, Macerata, Italy.Department of Anesthesiology, University Hospital of Heidelberg, Heidelberg, Germany.Department of General, Visceral, Thoracic, Transplant and Pediatric Surgery, University Hospital of Giessen, Giessen, Germany.Department of Pulmonary and Critical Care Medicine, University Hospital of Giessen and Marburg Lung Center (UGMLC), University Hospital of Giessen, Giessen, Germany.Department of General, Visceral and Oncologic Surgery, Hospital and Clinics Wetzlar, Wetzlar, Germany.Department of General, Visceral, Thoracic, Transplant and Pediatric Surgery, University Hospital of Giessen, Giessen, Germany.Department of General, Visceral, Thoracic, Transplant and Pediatric Surgery, University Hospital of Giessen, Giessen, Germany.Department of General, Visceral, Thoracic, Transplant and Pediatric Surgery, University Hospital of Giessen, Giessen, Germany.Department of General, Emergency and Trauma Surgery, Pisa University Hospital, Pisa, Italy.Department of Emergency Surgery, Parma Maggiore Hospital, Parma, Italy.Department of General, Visceral, Thoracic, Transplant and Pediatric Surgery, University Hospital of Giessen, Giessen, Germany. andreas.hecker@chiru.med.uni-giessen.de.No affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

33298131

Citation

Reichert, Martin, et al. "Impact of the SARS-CoV-2 Pandemic On Emergency Surgery Services-a Multi-national Survey Among WSES Members." World Journal of Emergency Surgery : WJES, vol. 15, no. 1, 2020, p. 64.
Reichert M, Sartelli M, Weigand MA, et al. Impact of the SARS-CoV-2 pandemic on emergency surgery services-a multi-national survey among WSES members. World J Emerg Surg. 2020;15(1):64.
Reichert, M., Sartelli, M., Weigand, M. A., Doppstadt, C., Hecker, M., Reinisch-Liese, A., Bender, F., Askevold, I., Padberg, W., Coccolini, F., Catena, F., & Hecker, A. (2020). Impact of the SARS-CoV-2 pandemic on emergency surgery services-a multi-national survey among WSES members. World Journal of Emergency Surgery : WJES, 15(1), 64. https://doi.org/10.1186/s13017-020-00341-0
Reichert M, et al. Impact of the SARS-CoV-2 Pandemic On Emergency Surgery Services-a Multi-national Survey Among WSES Members. World J Emerg Surg. 2020 12 9;15(1):64. PubMed PMID: 33298131.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Impact of the SARS-CoV-2 pandemic on emergency surgery services-a multi-national survey among WSES members. AU - Reichert,Martin, AU - Sartelli,Massimo, AU - Weigand,Markus A, AU - Doppstadt,Christoph, AU - Hecker,Matthias, AU - Reinisch-Liese,Alexander, AU - Bender,Fabienne, AU - Askevold,Ingolf, AU - Padberg,Winfried, AU - Coccolini,Federico, AU - Catena,Fausto, AU - Hecker,Andreas, AU - ,, Y1 - 2020/12/09/ PY - 2020/09/10/received PY - 2020/11/02/accepted PY - 2020/12/10/entrez PY - 2020/12/11/pubmed PY - 2020/12/22/medline KW - Appendicitis KW - COVID-19 KW - Cholecystitis KW - Emergency surgery KW - SARS-CoV-2 KW - WSES SP - 64 EP - 64 JF - World journal of emergency surgery : WJES JO - World J Emerg Surg VL - 15 IS - 1 N2 - BACKGROUND: The SARS-CoV-2 pandemic is a major challenge for health care services worldwide. It's impact on oncologic therapies and elective surgery has been described recently, and the literature provides guidelines regarding appropriate elective patient treatment during the pandemic. However, the impact of SARS-CoV-2 pandemic on emergency surgery services has been poorly investigated up to now. METHODS: A 17-item web survey had been distributed to emergency surgeons in June 2020 around the world, investigating the impact of SARS-CoV-2 pandemic on patients and septic diseases both requiring emergency surgery and the time-to-intervention in emergency surgery routine, as well as experiences with surgery in COVID-19 patients. RESULTS: Ninety-eight collaborators from 31 countries responded to the survey. The majority (65.3%) estimated the impact of the SARS-CoV-2 pandemic on emergency surgical patient care as being strong or very strong. Due to the pandemic, 87.8% reported a decrease in the total number of patients undergoing emergency surgery and approximately 25% estimated a delay of more than 2 h in the time-to-diagnosis and another 2 h in the time-to-intervention. Fifty percent make structural problems with in-hospital logistics (e.g. transport of patients, closed normal wards etc.) mainly responsible for delayed emergency surgery and the frequent need (56.1%) for a triage of emergency surgical patients. 56.1% of the collaborators observed more severe septic abdominal diseases during the pandemic, especially for perforated appendicitis and severe septic cholecystitis (41.8% and 40.2%, respectively). 62.2% had experiences with surgery in COVID-19-infected patients. CONCLUSIONS: The results of The WSES COVID-19 emergency surgery survey are alarming. The combination of an estimated decrease in numbers of emergency surgical patients and an observed increase in more severe septic diseases may be a result of the fear of patients from infection with COVID-19 and a consecutive delayed hospital admission and diagnosis. A critical delay in time-to-diagnosis and time-to-intervention may be a result of changes in in-hospital logistics and operating room as well as intensive care capacities. Both reflect the potentially harmful impact of SARS-CoV-2 pandemic on emergency surgery services. SN - 1749-7922 UR - https://www.unboundmedicine.com/medline/citation/33298131/Impact_of_the_SARS_CoV_2_pandemic_on_emergency_surgery_services_a_multi_national_survey_among_WSES_members_ L2 - https://wjes.biomedcentral.com/articles/10.1186/s13017-020-00341-0 DB - PRIME DP - Unbound Medicine ER -