Alsaigh Sultan, Harisi Mohammad, Almuhaymidi Reem, Al-Hojailan Abdullah A, Alharbi Abdulaziz Z, Alolayan Shahad S, Alqarzaee Razan S, Algosair Ibrahim
General Surgery, King Fahad Specialist Hopsital, Buraidah, SAU.
General Surgery, King Fahad Specialist Hospital, Buraidah, SAU.
Cureus. 2022 Nov 24;14(11):e31868. doi: 10.7759/cureus.31868. eCollection 2022 Nov.
The COVID-19 pandemic is a global disaster with millions of infections and deaths. Healthcare systems and services were significantly affected, necessitating adjustments. These included postponement of scheduled appointments and elective surgeries. During the pandemic, there was an increase in the number of acute appendicitis, gallstones, and hernia with a significant impact on the signs and symptoms of presenting problems due to prehospital delay.
This study aims to measure the impacts of COVID-19 on patients with common surgical emergencies in King Fahad Specialist Hospital, Buraidah, Saudi Arabia.
This is a single-center retrospective study conducted at King Fahad Specialist Hospital in Buraidah, Saudi Arabia. We reviewed all medical records of patients diagnosed with common surgical emergencies (acute appendicitis, gallstones, and hernia) during a selected time of COVID-19 lockdown and compared it with a similar set period before the crisis as a control sample. All medical records were reviewed to find out the overall number of admissions, frequency of emergency department (ED) visits, duration of illness, picture of clinical presentation, intraoperative findings, course and duration of admission, and final pathology if any.
A total of 322 patients were included in the study. Of these, 119 (37%) patients underwent surgery before COVID-19 while 203 (63%) patients underwent surgery during the pandemic. The diagnosis of acute appendicitis was 63.9% and 47.7%, hernia 27.7% and 34.6%, and gallstone was 8.4% and 17.7% for control and pandemic periods, respectively. The duration varied from 10 hours to two days and four hours to one month, seven hours to one day to eight hours to six months, and two hours to one day to seven hours to one and half a month for acute appendicitis, hernia, and gallstone in control and pandemic period, respectively. The mean length of stay for acute appendicitis was reduced from two days during the control period to one day during the pandemic period, from four to three days for gallstone, and for hernia, it remained three days for both the control and pandemic periods, respectively. Regarding the course of admission for acute appendicitis, the uneventful cases were reduced while an increase in uneventful cases for both hernia and gallstone was observed.
During the COVID-19 pandemic, there was a noticeable reduction in hospital visits. We observed an increase in the number of one-time visits and a reduction of three, four, and seven-time visits, which was attributed to the fact that patients have been reported to visit the hospital after a long time from the onset of symptoms with a higher chance of complication and subsequent surgeries. The number of acute appendicitis cases was reduced while the cases of hernia and gallstones increased significantly. The minimum period for the duration of acute illness for appendicitis was reduced in the pandemic period, while the minimum period for both gallstone and hernia was increased as both conditions could require conservative management. The mean length of hospital stay was reduced during the pandemic period, mainly due to the early discharge implemented in COVID-19 protocols to decrease the risk of infection. The severity of symptoms was increased due to the cancellation and delaying of surgeries.
新冠疫情是一场全球性灾难，导致数百万人感染和死亡。医疗系统和服务受到重大影响，需要进行调整。这些调整包括推迟预定的预约和择期手术。在疫情期间，急性阑尾炎、胆结石和疝气的病例数有所增加，且由于院前延误，对所呈现问题的体征和症状产生了重大影响。
本研究旨在衡量新冠疫情对沙特阿拉伯布赖代法赫德国王专科医院常见外科急症患者的影响。
这是一项在沙特阿拉伯布赖代法赫德国王专科医院进行的单中心回顾性研究。我们回顾了在新冠疫情封锁选定时间段内被诊断为常见外科急症（急性阑尾炎、胆结石和疝气）的患者的所有病历，并将其与危机前的类似时间段作为对照样本进行比较。审查所有病历以找出入院总数、急诊科就诊频率、病程、临床表现、术中发现、住院病程和时长，以及最终病理结果（如有）。
本研究共纳入322例患者。其中，119例（37%）患者在新冠疫情前接受了手术，而203例（63%）患者在疫情期间接受了手术。对照期和疫情期急性阑尾炎的诊断率分别为63.9%和47.7%，疝气分别为27.7%和34.6%，胆结石分别为8.4%和17.7%。急性阑尾炎、疝气和胆结石在对照期和疫情期的病程分别从10小时至2天、4小时至1个月、7小时至1天，变为8小时至6个月、2小时至1天、7小时至1个半月。急性阑尾炎的平均住院时长从对照期的2天降至疫情期的1天，胆结石从4天降至3天，疝气在对照期和疫情期均为3天。关于急性阑尾炎的住院病程，平稳病例减少，而疝气和胆结石的平稳病例增加。
在新冠疫情期间，医院就诊人数明显减少。我们观察到一次性就诊人数增加，三次、四次和七次就诊人数减少，这归因于据报道患者在出现症状很长时间后才去医院就诊，并发症和后续手术的几率更高。急性阑尾炎病例数减少，而疝气和胆结石病例数显著增加。疫情期间急性阑尾炎急性病期的最短时长缩短，而胆结石和疝气的最短时长增加，因为这两种情况都可能需要保守治疗。疫情期间平均住院时长缩短，主要是由于新冠疫情防控方案中实施的提前出院以降低感染风险。由于手术取消和推迟，症状严重程度增加。
