Abstract
BackgroundDuring the COVID-19 crisis it was necessary to generate a specific care network and reconvert operating rooms to attend emergency and high-acuity patients undergoing complex surgery. The aim of this study is to classify postoperative complications and mortality and to assess the impact that the COVID-19 pandemic may have had on the results.Methodsthis is a non-inferiority retrospective observational study. Two different groups of surgical patients were created: Pre-pandemic COVID and Pandemic COVID. Severity of illness was rated according to the Diagnosis-related Groups (DRG) score. Comparisons were made between groups and between DRG severity score-matched samples. Non-inferiority was set at up to 10 % difference for grade III to V complications according to the Clavien-Dindo classification, and up to 2 % difference in mortality.ResultsA total of 1649 patients in the PreCOVID group and 763 patients in the COVID group were analysed; 371 patients were matched for DRG severity score 3-4 (236 preCOVID and 135 COVID). No differences were found in relation to re-operation (22.5 % vs. 21.5 %) or late admission to critical care unit (5.1 % vs. 4.5 %). Clavien grade III to V complications occurred in 107 patients (45.3 %) in the PreCOVID group and in 56 patients (41.5 %) in the COVID group, and mortality was 12.7 % and 12.6 %, respectively. During the pandemic, 3 % of patients tested positive for Covid-19 on PCR: 12 patients undergoing elective surgery and 11 emergency surgery; there were 5 deaths, 3 of which were due to respiratory failure following Covid-19-induced pneumonia.ConclusionsAlthough this study has some limitations, it has shown the non-inferiority of surgical outcomes during the COVID pandemic, and indicates that resuming elective surgery is safe.Trial registrationClinicaltrials.gov identifier: NCT04780594.
Highlights
In December 2019, the disease produced by a new SARS-CoV-2coronavirus, named coronavirus disease (COVID)-19 (Coronavirus Disease 2019), was detected in Wuhan (Hubei Province, China)
Participants During the COVID period, 21 patients were excluded from the analysis because the procedure performed involved medical patients with COVID-19 infection
Four subgroups were created on the basis of the type of surgery: 1. Major scheduled surgery performed during the preCOVID-19 period
Summary
In December 2019, the disease produced by a new SARS-CoV-2coronavirus, named COVID-19 (Coronavirus Disease 2019), was detected in Wuhan (Hubei Province, China). The latest reports at the end of the first wave of the pandemic (24 May 2020) refer to a total of 235,290 confirmed cases, and a high percentage of hospitalisations for both conventional and critical care. During the peak of the COVID-19 health emergency, from 11 to 2020 to 15 May 2020, the ratio of patients admitted to hospital was nearly 200 per million population; the number of beds dedicated to COVID-19 infected patients increased. In various wards (Pneumology, Internal Medicine and Infectious Medicine), the highest number of COVID-19 patients admitted in one day during the pandemic was 396, and the number of critical care beds reserved for COVID19 patients increased to 108. During the COVID-19 crisis it was necessary to generate a specific care network and reconvert operat‐ ing rooms to attend emergency and high-acuity patients undergoing complex surgery. The aim of this study is to classify postoperative complications and mortality and to assess the impact that the COVID-19 pandemic may have had on the results
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
