COVID-19 pandemic did not affect emergency theatre patient demographic and length of stay in the first phase of UK countrywide lockdown in a district general hospital

Ann R Coll Surg Engl. 2021 Jun;103(6):404-411. doi: 10.1308/rcsann.2021.0043. Epub 2021 May 6.

Abstract

Introduction: We aim to identify any changes in outcome for patients undergoing nonelective surgery at the start of the UK pandemic in our district general hospital. This was a single-centre retrospective cohort review of a UK district general hospital serving a population of over 250,000 people.

Methods: Participants were all patients undergoing a surgical procedure in the acute theatre list between 23 March to 11 May in both 2019 and 2020. Primary outcome was 90-day postoperative mortality. Secondary outcomes include time to surgical intervention and length of inpatient stay.

Results: A total of 132 patients (2020) versus 141 (2019) patients were included. Although overall 90-day postoperative mortality was higher in 2020 (9.8%) compared with 2019 (5.7%), this difference was not statistically significant (p=0.196). In 2020, eight patients tested positive for COVID-19 either as an inpatient or within 2 weeks of discharge, of whom five patients died. Time to surgical intervention was significantly faster for NCEPOD (National Confidential Enquiry into Patient Outcome and Death) code 3 patients in 2020 than in 2019 (p=0.027). There were no significant differences in mean length of inpatient stay.

Conclusions: We found that patients were appropriately prioritised using NCEPOD classification, with no statistically significant differences in 90-day postoperative mortality and length of inpatient stay compared with the 2019 period. A study on a larger scale would further elucidate the profile and outcomes of patients requiring acute surgery to generate statistical significance.

Keywords: COVID-19; Emergency treatment; General surgery; Orthopaedic surgery; Surgery.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • COVID-19 / epidemiology*
  • Child
  • Child, Preschool
  • Communicable Disease Control* / methods
  • Emergency Treatment / statistics & numerical data*
  • Female
  • Hospitals, District / statistics & numerical data*
  • Hospitals, General / statistics & numerical data*
  • Humans
  • Length of Stay / statistics & numerical data*
  • Male
  • Middle Aged
  • Retrospective Studies
  • Surgical Procedures, Operative / adverse effects
  • Surgical Procedures, Operative / mortality
  • Surgical Procedures, Operative / statistics & numerical data*
  • Young Adult