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 2h in the time-to-diagnosis and another 2h 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.
Impact of the SARS-CoV-2 pandemic on emergency surgery services-a multi-national survey among WSES members / Reichert, Martin; Sartelli, Massimo; Weigand, Markus A; Doppstadt, Christoph; Hecker, Matthias; Reinisch-Liese, Alexander; Bender, Fabienne; Askevold, Ingolf; Padberg, Winfried; Coccolini, Federico; Catena, Fausto; Hecker, Andreas; Abakar, Abdullaev; Adrian, Camacho-Ortiz; Adriana, Toro; Alain, Chichom-Mefire; Aleix, Martínez-Pérez; Alfie, J Kavalakat; Ali Yasen Y, Mohamedahmed; Andrey,Litvin; Antonio, Brillantino; Antonio, Pesce; Arda, Isik; Aristotelis, Kechagias; Azzain M H, Ismail; Baris, Mantoglu; Basil, Ibrahim; Birgit, Hecker; Boris, Sakakushev; Charalampos, Seretis; Dimitrios, Manatakis; Edgar Fernando, Hernández García; Eli, olak; Elmin, Steyn; Emrah, Akin; Emre, Gonullu; Fabio Cesare, Campanile; Francesco, Pata; Francesco, Roscio; Fredrik, Linder; Gia, Tomadze; Gianluca, Pellino; Gianmaria, Casoni Pattacini; Giovanni, Pirozzolo; Gustavo M, Machain; Gustavo P, Fraga; Hazim Abdulnassir, Eltyeb; Ioannis, Nikolopoulos; Isidoro, Di Carlo; Jae Il, Kim; Jesus-Manuel, Saenz-Terrazas; Juan Carlos, Rodriguez Sanjuan; Juliane, Liese; Justin, Davies; Kim, Platte; Lawrence, Lottenberg; Leonardo, Pagani; Leonardo, Solaini; Lisa, Miller; Lovenish Bains, Luis Buonomo, Maciej Walędziak, Mahir Gachabayov, Marc Maegele, Marco Catarci, Marco Vittorio Rossi Ardizzone Alberio, Maria Grazia Alberio, Massimiliano Veroux, Matteo Nardi, Mauro Podda, Michael Sugrue, Michele Pisano, Mihail Slavchev, Mika Ukkonen, Miklosh Bala, Mircea Chirica, Mouaqit Ouadii, Orestis Ioannidis, Osvaldo Chiara, Pankaj Kumar, Per Örtenwall, Pradeep Navsaria, Raul Coimbra, Riccardo Somigli, Robert G Sawyer, Saad Shebrain, Salomone Di Saverio, Sanjay Marwah, Sergio Zegarra, Shahd Nour, Shahed Abdelmahmoud, Stefano Magnone, Syed Muhammad Ali, Tadeja Pintar, Tushar S Mishra, Valentina Tomajer, Varut Lohsiriwat, Vijay Shivpuje, Vladimir Khokha, Yoshiro Kobe, Zaza Demetrashvili. - In: WORLD JOURNAL OF EMERGENCY SURGERY. - ISSN 1749-7922. - ELETTRONICO. - 15:1(2020), pp. 64-74. [10.1186/s13017-020-00341-0]
Impact of the SARS-CoV-2 pandemic on emergency surgery services-a multi-national survey among WSES members
Leonardo, Solaini;
2020
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 2h in the time-to-diagnosis and another 2h 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.| File | Dimensione | Formato | |
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