3rd Department of Surgery, Attikon University Hospital, National and Kapodistrian University of Athens Medical School, Rimini Str. 1, 12462, Athens, Greece.
2nd Department of Internal Medicine-Propaedeutic, Attikon University Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece.
World J Emerg Surg. 2021 May 7;16(1):22. doi: 10.1186/s13017-021-00364-1.
The COVID-19 pandemic caused a rise in healthcare demands leading to significant restructuring of hospital emergency departments worldwide. The aim of the present study is twofold: firstly, to discern any differences in regard to reason for surgical emergency department (SED) attendance and hospital admission during the pandemic and pre-pandemic eras in Greece, and secondly, to assess the impact of the lockdown measures implemented during the pandemic on SED patient attendance.
Since the beginning of the COVID-19 pandemic in Greece (1 March 2020) and up to 15 December 2020, the charts of all adult patients arriving at the SED of the third surgical department of the "Attikon" University Hospital (a tertiary referral center for surgical and COVID-19 cases) were retrospectively reviewed and broken down in four periods reflecting two nationwide lockdown (period A 1/3/2020 to 30/4/2020 and period D 16/10/2020 to 15/12/2020) and two interim (period B 1/5/2020 to 15/6/2020 and period C 15/9/2020 to 30/10/2020) periods. Demographic and clinical data were compared to those obtained from the same time periods of the year 2019.
The total number of patients attending the SED decreased by 35.9% during the pandemic (from 2839 total patients in 2019 to 1819 in 2020). During the first lockdown, there was statistically significant reduction of motor vehicle accidents (p=0.04) and torso injuries (p=0.01). Contrarily, the rate of head injuries (p<0.001) and abdominal pain (p=0.04) were significantly increased. The same effect was observed regarding the rate of hospital admissions (p=0.002), although in terms of absolute numbers, admissions remained unchanged. During the second lockdown, there was a reduction in the number of perianal abscess cases (p=0.04) and hernia-related problems (p=0.001). An increase in the rate of fall injuries was also demonstrable (p=0.02). Overall, application of the lockdown led to a significant decrease in minor (p<0.001) and torso (p=0.001) injuries.
The burden of the new COVID-19 disease has left a noticeable imprint in the function of emergency departments worldwide. In Greece, SED attendance was significantly reduced during the pandemic, an effect that was even more pronounced during the lockdown implementation; nevertheless, the overall rate of hospital admissions remained the same, denoting that patient care was not altered.
新冠疫情导致全球医疗需求大幅增加，从而导致医院急诊部门进行了重大调整。本研究旨在达成两个目标：其一，分析希腊在新冠疫情期间和疫情前时期因外科急诊就诊和住院的原因是否存在差异；其二，评估新冠疫情期间实施的封锁措施对外科急诊就诊人数的影响。
自希腊新冠疫情（2020 年 3 月 1 日）开始至 2020 年 12 月 15 日，回顾了所有在三级转诊中心外科和新冠病例治疗中心（“Attikon”大学医院第三外科部）外科急诊就诊的成年患者的病历，并将其分为四个时期，反映了两次全国性封锁（时期 A：2020 年 3 月 1 日至 4 月 30 日；时期 D：2020 年 10 月 16 日至 12 月 15 日）和两个过渡时期（时期 B：2020 年 5 月 1 日至 6 月 15 日；时期 C：2020 年 9 月 15 日至 10 月 30 日）。将这些数据与 2019 年同期的数据进行比较。
在疫情期间，外科急诊就诊的总人数下降了 35.9%（从 2019 年的 2839 名患者降至 2020 年的 1819 名）。在第一次封锁期间，机动车事故（p=0.04）和躯干损伤（p=0.01）的数量明显减少。相反，头部损伤（p<0.001）和腹痛（p=0.04）的发生率显著增加。同样的效果也体现在住院率（p=0.002）上，尽管就绝对数量而言，住院人数保持不变。在第二次封锁期间，肛周脓肿病例（p=0.04）和疝相关问题（p=0.001）的数量有所减少。坠落伤的发生率也明显增加（p=0.02）。总体而言，封锁措施的实施导致轻微损伤（p<0.001）和躯干损伤（p=0.001）的显著减少。
新的 COVID-19 疾病对全球急诊部门的功能造成了显著影响。在希腊，外科急诊就诊人数在疫情期间显著减少，在封锁措施实施期间更为明显；然而，总的住院率保持不变，表明患者的治疗并未改变。
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