D'Urbano Francesco, Fabbri Nicolò, Koleva Radica Margherita, Rossin Eleonora, Carcoforo Paolo
Department of Morphology, Experimental Medicine and Surgery, Section of General Surgery, University of Ferrara, Ferrara 44100, Italy.
Unit of General Surgery, Azienda Unità Sanitaria Locale di Ferrara, Ferrara 44100, Italy.
World J Clin Cases. 2020 Sep 6;8(17):3691-3696. doi: 10.12998/wjcc.v8.i17.3691.
The current coronavirus disease 19 (COVID-19) pandemic is changing the organization of health care and has had a direct impact on the management of surgical patients.At the General Surgery Department of Sant'Anna University Hospital in Ferrara, Italy, surgical activities were progressively reduced during the peak of the COVID-19 outbreak in Italy. During this period, only one operating room was available for elective cancer surgeries and another for emergency surgeries. Moreover, the number of beds for surgical patients had to be reduced to provide beds and personnel for the new COVID-19 wards.
To compare 2 different period (from March 9 to April 9 2019 and from March 9 to April 9 2020), searching differences in terms of number and type of interventions in emergency surgery of a main University Hospital in Ferrara, a city in Emilia Romagna region, North of Italy.
This retrospective study was carried out at the General Surgery Department of Sant'Anna University Hospital in Ferrara, Italy. We examined the number of emergency surgeries performed and patient outcomes during the peak of the COVID-19 outbreak in Italy and subsequent total lockdown. We then drew a comparison with the number of surgeries performed and their outcomes during the same period in 2019. The study examined all adult patients who underwent emergency surgery from March 9 to April 9, 2019 ( = 46), and those who underwent surgery during the first month of the lockdown, from March 9 to April 9, 2020 ( = 27). Analyses were adjusted for age, gender, American Society of Anesthesiologists classification scores and types of surgery.
A total of 27 patients underwent emergency surgery at Sant'Anna University Hospital in Ferrara during the first month of the lockdown. This represents a 41.3% reduction in the number of patients who were hospitalized and underwent emergency surgery compared to the same period in 2019. The complication rate during the pandemic period was substantially higher than it was during the analogous period in 2019: 15 out of 27 cases from March 9 to April 9, 2020 (55) 17 out of 46 cases from March 9 to April 9, 2019 (36.9). Of the 27 patients who underwent emergency surgery during the pandemic, 10 were screened for COVID-19 using both thorax high resolution computerized tomography and a naso-pharyngeal swab, while 9 only underwent thorax high resolution computerized tomography. Only 1 patient tested positive for SARS-CoV-2 and died following surgery.
There was a significant reduction in emergency surgeries at our center during the COVID-19 pandemic, and it is plausible that there were analogous reductions at other centers across Italy.
当前的新型冠状病毒肺炎（COVID-19）大流行正在改变医疗保健的组织方式，并对外科患者的管理产生了直接影响。在意大利费拉拉的圣安娜大学医院普通外科，在意大利COVID-19疫情高峰期，外科手术活动逐渐减少。在此期间，只有一间手术室用于择期癌症手术，另一间用于急诊手术。此外，为了给新的COVID-19病房提供床位和人员，外科患者的床位数不得不减少。
比较两个不同时期（2019年3月9日至4月9日和2020年3月9日至4月9日），以探寻意大利北部艾米利亚-罗马涅地区费拉拉市一家主要大学医院急诊手术的干预数量和类型方面的差异。
这项回顾性研究在意大利费拉拉的圣安娜大学医院普通外科进行。我们检查了意大利COVID-19疫情高峰期及随后全面封锁期间进行的急诊手术数量和患者结局。然后我们将其与2019年同期进行的手术数量及其结局进行了比较。该研究检查了所有在2019年3月9日至4月9日接受急诊手术的成年患者（n = 46），以及在封锁的第一个月，即2020年3月9日至4月9日接受手术的患者（n = 27）。分析针对年龄、性别、美国麻醉医师协会分类评分和手术类型进行了调整。
在封锁的第一个月，费拉拉的圣安娜大学医院共有27例患者接受了急诊手术。与2019年同期相比，住院并接受急诊手术的患者数量减少了41.3%。大流行期间的并发症发生率明显高于2019年的类似时期：2020年3月9日至4月9日的27例中有15例（55%），2019年3月9日至4月9日的46例中有17例（36.9%）。在大流行期间接受急诊手术的27例患者中，10例使用胸部高分辨率计算机断层扫描和鼻咽拭子进行了COVID-19筛查，而9例仅接受了胸部高分辨率计算机断层扫描。只有1例患者SARS-CoV-2检测呈阳性并在手术后死亡。
在COVID-19大流行期间，我们中心的急诊手术显著减少，意大利其他中心可能也有类似的减少情况。
