1369 Clinical Outcomes in Patients Undergoing Emergency General Surgery During the Covid-19 Pandemic Versus Control Patients: A Systematic Review and Meta-Analysis

Abstract

Abstract Introduction Throughout the Covid-19 pandemic, the surgical community has attempted to address whether it is safe to continue surgery. The aim of this research was to review evidence on emergency general patients operated on during the pandemic compared to patients undergoing emergency surgery during non-pandemic times to determine if operating during the Covid-19 pandemic led to an increased risk of death, length of hospital stay and complications. Method A systematic review of the literature was performed. PubMed, Cochrane, MEDLINE, Science Direct, Springer Link, Elsevier, and reference lists were analysed for inclusion on 2 January 2021. Results Nine studies and 5,022 patients were included. There were no significant differences in the control group vs pandemic group in mean age (52.3yrs vs 51.9yrs, p = 0.67) or gender (44.4% females vs 49.3%, p = 0.173). Pooled analysis of control vs pandemic showed a mortality rate of 1.26% vs 3.06% (CI:-6.58–6.58, p = 1.00). Mean length of hospital stay was 7.9 vs 7.7 days in control v. pandemic (CI: -2.93-3.33, p = 0.87) and post-operative complication rate of 20.2% vs 25.7% (CI -6.4-25.0, p = 0.20), (control vs pandemic). The pandemic group had significantly more operative management (47.0% vs 40.0%, p = 0.03) with no significant difference in laparoscopic vs open technique (46.0% vs 43.6%, p = 0.20). Conclusions This meta-analysis shows there is no statistically significant difference in mortality rate, length of hospital stay and postoperative complication rate between the pandemic and control cohorts in emergency general surgery patients. This data suggests that general emergency surgery should continue in spite of the pandemic with appropriate precautions in place.