Retrospective Study
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Sep 6, 2020; 8(17): 3691-3696
Published online Sep 6, 2020. doi: 10.12998/wjcc.v8.i17.3691
Emergency surgery in COVID-19 outbreak: Has anything changed? Single center experience
Francesco D'Urbano, Nicolò Fabbri, Margherita Koleva Radica, Eleonora Rossin, Paolo Carcoforo
Francesco D'Urbano, Margherita Koleva Radica, Eleonora Rossin, Paolo Carcoforo, Department of Morphology, Experimental Medicine and Surgery, Section of General Surgery, University of Ferrara, Ferrara 44100, Italy
Nicolò Fabbri, Unit of General Surgery, Azienda Unità Sanitaria Locale di Ferrara, Ferrara 44100, Italy
Author contributions: D'Urbano F, Fabbri N, Carcoforo P were involved in the study conceptualization, data curation, funding acquisition, investigation, project administration, supervision of the study, provision of resources and writing of the original draft; D'Urbano F, Fabbri N, Koleva Radica M, Rossin E, Carcoforo P were performed the data curation and formal analysis, and participated in the investigation, methodology design, software utilization, data visualization, and writing, review and editing of the manuscript; all authors have read and approve the final manuscript.
Institutional review board statement: This study was reviewed and approved by the Ethics Committee of the Area Vasta Emilia Centro, Italy.
Informed consent statement: Patients were not required to give informed consent to the study because the high risk of biological contamination. The analysis used anonymous clinical data that were obtained after each patient agreed to treatment by written consent.
Conflict-of-interest statement: We have no financial relationships to disclose.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Nicolò Fabbri, MD, Surgeon, Unit of General Surgery, Azienda Unità Sanitaria Locale di Ferrara, Via Arturo Cassoli, 30, Ferrara, Ferrara 44100, Italy. n.fabbri@ausl.fe.it
Received: May 23, 2020
Peer-review started: May 23, 2020
First decision: June 19, 2020
Revised: July 22, 2020
Accepted: August 27, 2020
Article in press: August 27, 2020
Published online: September 6, 2020
Processing time: 104 Days and 1.9 Hours
ARTICLE HIGHLIGHTS
Research background

The current coronavirus disease 19 pandemic is changing the organization of health care and has had a direct impact on the management of surgical patients.

Research motivation

In this article, we highlight how this outbreak could change the flow of surgical patients for many reasons, compared to the same period before pandemic in the main University hospital with an urban population.

Research objectives

This study wants to compare 2 different period (from March 9 to April 9 2019 and from March 9 to April 9 2020), searching differences in terms of number and type of interventions in emergency surgery of a main University Hospital in Ferrara, a city in Emilia Romagna region, North of Italy.

Research methods

Data were retrospectively collected using SAP (Systeme, Anwendungen, Produkte in der Datenverarbeitung) database and the Ormaweb (Dedalus Spa) operating registry.

Research results

A total of 27 patients underwent emergency surgery at Sant’Anna University Hospital in Ferrara during the first month of lock down, between March 9 and April 9, 2020 compared to 46 patients who underwent emergency surgery in the same period in 2019. The complication rate during the pandemic increased substantially to 15 out of 27 cases (55.5), compared to 17 out of 46 cases (36.9) recorded in 2019. The mean length of hospitalization in 2019 was 16.5 d, ranging from 1 to 53 d, while in 2020, it was 12.9 d, ranging from 3 to 35 d. The fatality rate after surgery during the pandemic decreased to (11.1) compared to the (19.6) rate recorded in 2019.

Research conclusions

There was a significant reduction in emergency surgeries at our center and it is plausible that an analogous reduction will occur in other hospitals.

Research perspectives

It is desirable that the countries affected by the pandemic reorganize their surgical activities and health workers.