The impact of the COVID-19 outbreak on emergency general surgery in the first German "hotspot region" Aachen-Heinsberg-A multicentre retrospective cohort study.
Journal
PloS one
ISSN: 1932-6203
Titre abrégé: PLoS One
Pays: United States
ID NLM: 101285081
Informations de publication
Date de publication:
2023
2023
Historique:
received:
10
03
2022
accepted:
10
01
2023
entrez:
25
1
2023
pubmed:
26
1
2023
medline:
28
1
2023
Statut:
epublish
Résumé
This study aimed to observe the impact of the COVID-19 outbreak on acute general surgery in the first German "hotspot" regions of Heinsberg and Aachen, during the first months of the pandemic. The incidence and severity of acute appendicitis, acute cholecystitis and mechanical bowel obstruction, were compared between March and May 2020 and a control period (same months of the previous three years). Pre-, intra- and postoperative data was compared between three regional hospitals of Heinsberg and the closest maximum care, university hospital. A total of 592 operated patients were included, 141 belonging to the pandemic cohort and 451 to the historic cohort. The pandemic group showed higher rates of clinical peritonitis (38% vs. 27%, p = 0.015), higher rates of mean white blood cell count (13.2±4.4 /nl vs. 12.3±4.7 /nl, p = 0.044) and mean C-reactive protein (60.3±81.1 mg/l vs. 44.4±72.6 mg/l, p = 0.015) preoperatively. Specifically in patients with acute appendicitis, there were less patients with catarrhal appendicitis (23% vs. 35%, p = 0.021) and a tendency towards more advanced histological findings in the pandemic cohort. In the university hospital, a 42% reduction in acute operated cases was observed at the onset of the pandemic (n = 30 in 2020 vs. n = 52 in 2019), whereas in the peripheral hospitals of Heinsberg there was only a 10% reduction (n = 111 in 2020 vs. n = 123 in 2019). The onset of the COVID-19 pandemic in our region was accompanied by advanced preoperative and intraoperative findings in patients undergoing emergency general surgery. A greater reduction in acute operated surgical cases was observed at the university hospital, in contrast to the smaller hospitals of Heinsberg, suggesting a possible shift of emergency patients, requiring immediate operation, from maximum care hospital to the periphery.
Identifiants
pubmed: 36696422
doi: 10.1371/journal.pone.0280867
pii: PONE-D-22-07208
pmc: PMC9876361
doi:
Banques de données
Dryad
['10.5061/dryad.4b8gthtg0']
Types de publication
Multicenter Study
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
e0280867Informations de copyright
Copyright: © 2023 Chrysos et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Déclaration de conflit d'intérêts
The authors have declared that no competing interests exist.
Références
PLoS Med. 2007 Oct 16;4(10):e296
pubmed: 17941714
Euro Surveill. 2020 Mar;25(9):
pubmed: 32156327
Ann Surg. 2020 Jul;272(1):e5-e6
pubmed: 32221118
J Trauma Acute Care Surg. 2020 Jun;88(6):719-724
pubmed: 32267661
Lancet Child Adolesc Health. 2020 May;4(5):e10-e11
pubmed: 32278365
Ann Surg. 2013 Jul;258(1):1-7
pubmed: 23728278
Br J Surg. 2020 Jun;107(7):785-787
pubmed: 32191340
J Trauma Acute Care Surg. 2020 Dec;89(6):1085-1091
pubmed: 32890343
Int J Surg. 2020 Jul;79:180-188
pubmed: 32454253
Nature. 2020 Apr;580(7803):E7
pubmed: 32296181
Nature. 2020 Mar;579(7798):265-269
pubmed: 32015508
Int J Surg. 2020 Aug;80:157-161
pubmed: 32679205
Dtsch Med Wochenschr. 2020 May;145(10):665-669
pubmed: 32428957
Int J Surg. 2020 Jul;79:168-179
pubmed: 32407799
Scott Med J. 2020 Nov;65(4):144-148
pubmed: 32878574
Ann Transl Med. 2016 Oct;4(19):362
pubmed: 27826565
Swiss Med Wkly. 2020 Mar 24;150:w20227
pubmed: 32208493
Lancet. 2020 Feb 15;395(10223):496
pubmed: 32061297
Lancet. 2020 Feb 15;395(10223):497-506
pubmed: 31986264
Ann Surg. 2009 Aug;250(2):187-96
pubmed: 19638912
World J Surg. 2020 Aug;44(8):2458-2463
pubmed: 32458019
Updates Surg. 2020 Jun;72(2):309-310
pubmed: 32328880
JAMA Surg. 2016 Jun 15;151(6):e160480
pubmed: 27120712
Langenbecks Arch Surg. 2020 May;405(3):359-364
pubmed: 32385568
J Am Coll Radiol. 2020 Aug;17(8):1011-1013
pubmed: 32610104
J Am Coll Radiol. 2021 Nov;18(11):1473
pubmed: 34562413
Int J Surg. 2020 Jul;79:233-248
pubmed: 32413502