Delivering Safe Surgical Care While Simultaneously Caring for Patients With COVID-19; Assessment of Patient Selection, Volume and Outcomes in a Tertiary Care Hospital

• DOI: 10.3389/ijph.2023.1605640
• Publication Date: 2023-03-27T04:11:25Z
• Authors: Anja Domenghino; Roxane Diane Staiger; Fariba Abbassi; Miquel Serra-Burriel; Kim Leutwyler; Guillaume Aeby; Matthias Turina; Christian Alexand...; Pierre-Alain Clavien; Milo Alan Puhan
• Keywords: quality assessment; complications; SARS-CoV-2; pandemic; Public Health Archive; Patient Selection; Comprehensive Complication Index (CCI®); COVID-19; 610 Medicine & health; 10060 Epidemiology, Biostatistics and Prevention Institute (EBPI); 2739 Public Health, Environmental and Occupational Health; Length of Stay; 3. Good health; Tertiary Care Centers; surgical quality; Clavien-Dindo classification; Humans; Patient Care; Public aspects of medicine; RA1-1270; Retrospective Studies

Objectives: Compare patient selection and postoperative outcomes after surgical treatment for gastrointestinal disorders before and during the SARS-CoV-2 pandemic.Methods: We assessed gastrointestinal surgeries conducted at a tertiary center from 2017–2021 for differences in patient populations and procedures before (up to February 2020) and during the pandemic (March 2020 to December 2021). We analyzed mortality, Intensive Care Unit (ICU) length of stay, admission to ICU and postoperative complications for complex procedures using descriptive statistics and regression models.Results: 7309 procedures were analyzed, showing a caseload reduction in March and October 2020, but no statistical evidence for fewer overall procedures overall. Population characteristics differed with lower Body Mass Indices in 2020 and 2021, more patients smoking and with diabetes treated in 2020. There was no increased mortality, ICU length of stay and in 1,144 complex procedures assessed low overall morbidity at 90 days postoperative.Conclusion: Delivering surgical care while treating patients for COVID-19 in the same hospital was safe. Healthcare officials should consider continuing surgical care during future health crises as consequences of limiting surgical treatment for gastrointestinal disorders may be fatal for patients.