Key result
The COVID-19 pandemic lockdown was associated with a significant increase in post-operative complications following abdominal surgery compared to the pre-pandemic period (53.9% vs 46.1%, p=0.001).
Why the study?
The study was conducted to evaluate the emergency experience, delay of elective abdominal surgical intervention, and post-operative morbidity and mortality before and during the COVID-19 pandemic.
Does the COVID-19 pandemic lockdown impact post-operative morbidity and mortality in patients undergoing abdominal surgery?
Cohort (n=656)
No
Does the COVID-19 pandemic lockdown impact post-operative morbidity and mortality in patients undergoing abdominal surgery?
Absolute Event Rate: 53.9% vs 46.1%
p-value: p=0.001
The COVID-19 pandemic lockdown was associated with a significant reduction in surgical volume but increased post-operative morbidity, mortality, and length of stay for abdominal surgeries.
May indicate pandemic-related delays in elective abdominal surgery; leaves open effects on morbidity and mortality.
The SARS-CoV-2 pandemic’s main concerns are limiting the spread of infectious diseases and upgrading the delivery of health services, infrastructure, and therapeutic provision. The goal of this retrospective cohort study was to evaluate the emergency experience and delay of elective abdominal surgical intervention at King Abdul-Aziz University Hospital from October 2019 to October 2020, with a focus on post-operative morbidity and mortality before and during the COVID-19 pandemic. This study compares two groups of patients with emergent and elective abdominal surgical procedures between two different periods; the population was divided into two groups: the control group, which included 403 surgical patients, and the lockdown group, which included 253 surgical patients. During the lockdown, surgical activity was reduced by 37.2% (p = 0.014), and patients were more likely to require reoperations and blood transfusions during or after surgery (p= 0.002, 0.021, and 0.018, respectively). During the lockdown period, the average length of stay increased from 3.43 to 5.83 days (p = 0.002), and the patients who developed complications (53.9%) were more than those in the control period (46.1%) (p = 0.001). Our tertiary teaching hospital observed a significant decline in the overall number of surgeries performed during the COVID-19 pandemic and lockdown period. During the lockdown, abdominal surgery was performed only on four patients; they were positive for COVID-19. Three of them underwent exploratory laparotomy; two of the three developed shock post-operative; one patient had colon cancer (ASA score 3), one had colon disease (ASA score 2), and two had perforated bowels (ASA scores 2 and 4, respectively). Two out of four deaths occurred after surgery. Our results showed the impact of the COVID-19 lockdown on surgical care as both 30-day mortality and total morbidity have risen considerably.
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Alelyani et al. (2022) conducted a cohort in Patients undergoing elective and emergency abdominal surgery (n=656). COVID-19 pandemic lockdown vs. Pre-pandemic control period was evaluated on Post-operative complications (p=0.001). The COVID-19 pandemic lockdown was associated with a significant increase in post-operative complications following abdominal surgery compared to the pre-pandemic period (53.9% vs 46.1%, p=0.001).
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