de Bock Ellen, Filipe Mando D, Pronk Apollo, Boerma Djamila, Heikens Joost T, Verheijen Paul M, Vriens Menno R, Richir Milan C
Department of Surgery, Cancer Centre, University Medical Centre Utrecht, the Netherlands.
Department of Surgery, Diakonessenhuis, Utrecht, the Netherlands.
Int J Surg Open. 2021 Sep;35:100397. doi: 10.1016/j.ijso.2021.100397. Epub 2021 Aug 24.
Coronavirus disease 2019 (COVID-19) has influenced (surgical) care worldwide. Measures were taken to prioritize surgical care in order to maintain capacity for COVID-19 healthcare. However, the influence of these measures on emergency surgery is limited. Therefore, the aim of this study is to describe the trends in emergency surgery and determine the factors influencing the risk of postoperative complications during the first wave of the COVID-19 pandemic.
This multicentre retrospective cohort study investigated all emergency patients operated on from March 9th to June 30th, 2020. The primary endpoint was identifying the number of emergency surgical procedures performed. Secondary endpoints were determining the number of postoperative complications and factors determining the risk of postoperative complications, which were calculated by multivariate analysis with odds ratio (OR) and 95% confidence (CI) intervals.
In total, 1399 patients who underwent an emergency surgical procedure were included. An increase in the number of emergency vascular and trauma surgical procedures occurred during the study period. In contrast, the number of emergency general and oncological surgical procedures performed remained stable. An increased age (OR 1.01, 95% CI 1.00-1.02; p = 0.024), American Society of Anaesthesiologists (ASA) (OR 1.34, 95% CI 1.09-1.64; p = 0.005), and surgical discipline were independent predictors for an increased risk of postoperative complications.
The performance of emergency vascular and trauma surgical procedures increased. The performance of emergency general and oncological surgical procedures remained stable. In addition, increased age, ASA, and surgical discipline were independent predictors for an increased risk of postoperative complications.
2019年冠状病毒病（COVID-19）已对全球（外科）医疗护理产生影响。已采取措施对手术护理进行优先排序，以维持应对COVID-19医疗保健的能力。然而，这些措施对急诊手术的影响有限。因此，本研究的目的是描述急诊手术的趋势，并确定在COVID-19大流行第一波期间影响术后并发症风险的因素。
这项多中心回顾性队列研究调查了2020年3月9日至6月30日期间接受急诊手术的所有患者。主要终点是确定急诊手术的数量。次要终点是确定术后并发症的数量以及决定术后并发症风险的因素，这些因素通过多变量分析计算比值比（OR）和95%置信区间（CI）得出。
总共纳入了1399例接受急诊手术的患者。在研究期间，急诊血管和创伤外科手术的数量有所增加。相比之下，急诊普通外科和肿瘤外科手术的数量保持稳定。年龄增加（OR 1.01，95% CI 1.00 - 1.02；p = 0.024）、美国麻醉医师协会（ASA）分级（OR 1.34，95% CI 1.09 - 1.64；p = 0.005）以及手术科室是术后并发症风险增加的独立预测因素。
急诊血管和创伤外科手术的实施量增加。急诊普通外科和肿瘤外科手术的实施量保持稳定。此外，年龄增加、ASA分级以及手术科室是术后并发症风险增加的独立预测因素。
