Impact of the COVID-19 pandemic on surgical care in the Netherlands.
Journal
The British journal of surgery
ISSN: 1365-2168
Titre abrégé: Br J Surg
Pays: England
ID NLM: 0372553
Informations de publication
Date de publication:
22 11 2022
22 11 2022
Historique:
received:
21
02
2022
revised:
14
05
2022
accepted:
31
07
2022
entrez:
22
2
2023
pubmed:
23
2
2023
medline:
25
2
2023
Statut:
ppublish
Résumé
The COVID-19 pandemic caused disruption of regular healthcare leading to reduced hospital attendances, repurposing of surgical facilities, and cancellation of cancer screening programmes. This study aimed to determine the impact of COVID-19 on surgical care in the Netherlands. A nationwide study was conducted in collaboration with the Dutch Institute for Clinical Auditing. Eight surgical audits were expanded with items regarding alterations in scheduling and treatment plans. Data on procedures performed in 2020 were compared with those from a historical cohort (2018-2019). Endpoints included total numbers of procedures performed and altered treatment plans. Secondary endpoints included complication, readmission, and mortality rates. Some 12 154 procedures were performed in participating hospitals in 2020, representing a decrease of 13.6 per cent compared with 2018-2019. The largest reduction (29.2 per cent) was for non-cancer procedures during the first COVID-19 wave. Surgical treatment was postponed for 9.6 per cent of patients. Alterations in surgical treatment plans were observed in 1.7 per cent. Time from diagnosis to surgery decreased (to 28 days in 2020, from 34 days in 2019 and 36 days in 2018; P < 0.001). For cancer-related procedures, duration of hospital stay decreased (5 versus 6 days; P < 0.001). Audit-specific complications, readmission, and mortality rates were unchanged, but ICU admissions decreased (16.5 versus 16.8 per cent; P < 0.001). The reduction in the number of surgical operations was greatest for those without cancer. Where surgery was undertaken, it appeared to be delivered safely, with similar complication and mortality rates, fewer admissions to ICU, and a shorter hospital stay. COVID-19 has had a significant impact on healthcare worldwide. Hospital visits were reduced, operating facilities were used for COVID-19 care, and cancer screening programmes were cancelled. This study describes the impact of the COVID-19 pandemic on Dutch surgical healthcare in 2020. Patterns of care in terms of changed or delayed treatment are described for patients who had surgery in 2020, compared with those who had surgery in 2018–2019. The study found that mainly non-cancer surgical treatments were cancelled during months with high COVID-19 rates. Outcomes for patients undergoing surgery were similar but with fewer ICU admissions and shorter hospital stay. These data provide no insight into the burden endured by patients who had postponed or cancelled operations.
Sections du résumé
BACKGROUND
The COVID-19 pandemic caused disruption of regular healthcare leading to reduced hospital attendances, repurposing of surgical facilities, and cancellation of cancer screening programmes. This study aimed to determine the impact of COVID-19 on surgical care in the Netherlands.
METHODS
A nationwide study was conducted in collaboration with the Dutch Institute for Clinical Auditing. Eight surgical audits were expanded with items regarding alterations in scheduling and treatment plans. Data on procedures performed in 2020 were compared with those from a historical cohort (2018-2019). Endpoints included total numbers of procedures performed and altered treatment plans. Secondary endpoints included complication, readmission, and mortality rates.
RESULTS
Some 12 154 procedures were performed in participating hospitals in 2020, representing a decrease of 13.6 per cent compared with 2018-2019. The largest reduction (29.2 per cent) was for non-cancer procedures during the first COVID-19 wave. Surgical treatment was postponed for 9.6 per cent of patients. Alterations in surgical treatment plans were observed in 1.7 per cent. Time from diagnosis to surgery decreased (to 28 days in 2020, from 34 days in 2019 and 36 days in 2018; P < 0.001). For cancer-related procedures, duration of hospital stay decreased (5 versus 6 days; P < 0.001). Audit-specific complications, readmission, and mortality rates were unchanged, but ICU admissions decreased (16.5 versus 16.8 per cent; P < 0.001).
CONCLUSION
The reduction in the number of surgical operations was greatest for those without cancer. Where surgery was undertaken, it appeared to be delivered safely, with similar complication and mortality rates, fewer admissions to ICU, and a shorter hospital stay.
COVID-19 has had a significant impact on healthcare worldwide. Hospital visits were reduced, operating facilities were used for COVID-19 care, and cancer screening programmes were cancelled. This study describes the impact of the COVID-19 pandemic on Dutch surgical healthcare in 2020. Patterns of care in terms of changed or delayed treatment are described for patients who had surgery in 2020, compared with those who had surgery in 2018–2019. The study found that mainly non-cancer surgical treatments were cancelled during months with high COVID-19 rates. Outcomes for patients undergoing surgery were similar but with fewer ICU admissions and shorter hospital stay. These data provide no insight into the burden endured by patients who had postponed or cancelled operations.
Autres résumés
Type: plain-language-summary
(eng)
COVID-19 has had a significant impact on healthcare worldwide. Hospital visits were reduced, operating facilities were used for COVID-19 care, and cancer screening programmes were cancelled. This study describes the impact of the COVID-19 pandemic on Dutch surgical healthcare in 2020. Patterns of care in terms of changed or delayed treatment are described for patients who had surgery in 2020, compared with those who had surgery in 2018–2019. The study found that mainly non-cancer surgical treatments were cancelled during months with high COVID-19 rates. Outcomes for patients undergoing surgery were similar but with fewer ICU admissions and shorter hospital stay. These data provide no insight into the burden endured by patients who had postponed or cancelled operations.
Identifiants
pubmed: 36811624
pii: 6692504
doi: 10.1093/bjs/znac301
pmc: PMC10364688
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1282-1292Investigateurs
J N Helleman
(JN)
C L Koningswoud-Terhoeve
(CL)
E Belt
(E)
J A B van der Hoeven
(JAB)
G M H Marres
(GMH)
F Tozzi
(F)
E M von Meyenfeldt
(EM)
R R J Coebergh-van den Braak
(RRJ)
S Huisman
(S)
A M Rijken
(AM)
R Balm
(R)
F Daams
(F)
C Dickhoff
(C)
W J Eshuis
(WJ)
S S Gisbertz
(SS)
H R Zandbergen
(HR)
K J Hartemink
(KJ)
S A Keessen
(SA)
N F M Kok
(NFM)
K F D Kuhlmann
(KFD)
J W van Sandick
(JW)
A A Veenhof
(AA)
A Wals
(A)
M S van Diepen
(MS)
L Schoonderwoerd
(L)
C T Stevens
(CT)
D Susa
(D)
B L W Bendermacher
(BLW)
N Olofsen
(N)
M van Himbeeck
(M)
I H J T de Hingh
(IHJT)
H J B Janssen
(HJB)
M D P Luyer
(MDP)
G A P Nieuwenhuijzen
(GAP)
M Ramaekers
(M)
R Stacie
(R)
A K Talsma
(AK)
M W Tissink
(MW)
D Dolmans
(D)
R Berendsen
(R)
J Heisterkamp
(J)
W A Jansen
(WA)
M de Kort-van Oudheusden
(M)
R M Matthijsen
(RM)
D J Grünhagen
(DJ)
S M Lagarde
(SM)
A P W M Maat
(APWM)
P C van der Sluis
(PC)
R B Waalboer
(RB)
V Brehm
(V)
J P van Brussel
(JP)
M Morak
(M)
E D Ponfoort
(ED)
J E M Sybrandy
(JEM)
P L Klemm
(PL)
W Lastdrager
(W)
H W Palamba
(HW)
S M van Aalten
(SM)
L N L Tseng
(LNL)
K E A van der Bogt
(KEA)
W J de Jong
(WJ)
J W A Oosterhuis
(JWA)
Q Tummers
(Q)
G M van der Wilden
(GM)
S Ooms
(S)
E H Pasveer
(EH)
H T C Veger
(HTC)
M J Molegraafb
(MJ)
V B Nieuwenhuijs
(VB)
G A Patijn
(GA)
M E V van der Veldt
(MEV)
D Boersma
(D)
S T W van Haelst
(STW)
I D van Koeverden
(ID)
M L Rots
(ML)
B A Bonsing
(BA)
N Michiels
(N)
O D Bijlstra
(OD)
J Braun
(J)
D Broekhuis
(D)
H W Brummelaar
(HW)
H H Hartgrink
(HH)
A Metselaar
(A)
J S D Mieog
(JSD)
I B Schipper
(IB)
W O de Steur
(WO)
B Fioole
(B)
E C Terlouw
(EC)
C Biesmans
(C)
J W A M Bosmans
(JWAM)
S A W Bouwense
(SAW)
S H E M Clermonts
(SHEM)
M M E Coolsen
(MME)
B M E Mees
(BME)
G W H Schurink
(GWH)
J W Duijff
(JW)
T van Gent
(T)
L C F de Nes
(LCF)
D Toonen
(D)
M J Beverwijk
(MJ)
E van den Hoed
(E)
B Keizers
(B)
W Kelder
(W)
B P J A Keller
(BPJA)
B B Pultrum
(BB)
E van Rosum
(E)
A G Wijma
(AG)
F van den Broek
(F)
W K G Leclercq
(WKG)
M J A Loos
(MJA)
J M L Sijmons
(JML)
R H D Vaes
(RHD)
P J Vancoillie
(PJ)
E C J Consten
(ECJ)
J M J Jongen
(JMJ)
P M Verheijen
(PM)
V van Weel
(V)
C H P Arts
(CHP)
J Jonker
(J)
G Murrmann-Boonstra
(G)
J P E N Pierie
(JPEN)
J Swart
(J)
E B van Duyn
(EB)
R H Geelkerken
(RH)
R de Groot
(R)
N L Moekotte
(NL)
A Stam
(A)
A Voshaar
(A)
G J D van Acker
(GJD)
R M A Bulder
(RMA)
D J Swank
(DJ)
I T A Pereboom
(ITA)
W H Hoffmann
(WH)
M Orsini
(M)
J J Blok
(JJ)
J H P Lardenoije
(JHP)
M M P J Reijne
(MMPJ)
P van Schaik
(P)
L Smeets
(L)
S M M van Sterkenburg
(SMM)
N J Harlaar
(NJ)
S Mekke
(S)
T Verhaakt
(T)
E Cancrinus
(E)
G W van Lammeren
(GW)
I Q Molenaar
(IQ)
H C van Santvoort
(HC)
A W F Vos
(AWF)
A P Schouten-van der Velden
(AP)
K Woensdregt
(K)
S P Mooy-Vermaat
(SP)
D M Scharn
(DM)
H A Marsman
(HA)
F Rassam
(F)
F R Halfwerk
(FR)
A J Andela
(AJ)
C I Buis
(CI)
G M van Dam
(GM)
K Ten Duis
(K)
B van Etten
(B)
L Lases
(L)
M Meerdink
(M)
V E de Meijer
(VE)
B Pranger
(B)
S Ruiter
(S)
M Rurenga
(M)
A Wiersma
(A)
A R Wijsmuller
(AR)
K I Albers
(KI)
P B van den Boezem
(PB)
B Klarenbeek
(B)
B M van der Kolk
(BM)
C J H M van Laarhoven
(CJHM)
E Matthée
(E)
N Peters
(N)
C Rosman
(C)
A M A Schroen
(AMA)
M W J Stommel
(MWJ)
A F T M Verhagen
(AFTM)
R van der Vijver
(R)
M C Warlé
(MC)
J H W de Wilt
(JHW)
J W van den Berg
(JW)
T Bloemert
(T)
G J de Borst
(GJ)
E H van Hattum
(EH)
C E V B Hazenberg
(CEVB)
J A van Herwaarden
(JA)
R van Hillegerberg
(R)
T E Kroese
(TE)
B J Petri
(BJ)
R J Toorop
(RJ)
F Aarts
(F)
R J L Janssen
(RJL)
S H P Janssen-Maessen
(SHP)
M Kool
(M)
H Verberght
(H)
D E Moes
(DE)
J W Smit
(JW)
A M Wiersema
(AM)
B P Vierhout
(BP)
B de Vos
(B)
F C den Boer
(FC)
N A M Dekker
(NAM)
J M J Botman
(JMJ)
M J van Det
(MJ)
E C Folbert
(EC)
E de Jong
(E)
J C Koenen
(JC)
E A Kouwenhoven
(EA)
I Masselink
(I)
L H Navis
(LH)
H J Belgers
(HJ)
M N Sosef
(MN)
J H M B Stoot
(JHMB)
Informations de copyright
© The Author(s) 2022. Published by Oxford University Press on behalf of BJS Society Ltd.
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