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. 2020 Jun 27;102(6):1-6.
doi: 10.1308/rcsann.2020.0147. Online ahead of print.

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

R Patel  1 , A J Hainsworth  1 , K Devlin  2 , J H Patel  2 , A Karim  1
Affiliations

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

R Patel et al. Ann R Coll Surg Engl. .

Abstract

Introduction: 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.

Materials and methods: 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.

Results: 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, p = 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%, p = 0.01). Length of hospital stay was significantly shorter during lockdown compared with pre-lockdown (5 days vs 4 days, p = 0.04).

Conclusion: 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.

Keywords: COVID-19; Coronavirus; Emergency service; General surgery; Pandemic.

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Figures

Figure 1
Figure 1
The National Early Warning Score 2 for group 1 (mean 1, median 1, interquartile range 1–1) and group 2 (mean 1.5, median 1, interquartile range 0–2) presented as a box and whisker plot
Figure 2
Figure 2
The percentage of patients with each type of presenting complaint in each group
Figure 3
Figure 3
The percentage of patients with each type of diagnosis in each group
See this image and copyright information in PMC

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