Impact of the COVID-19 Pandemic on Elective and Emergency Surgeries, and Postoperative Mortality in a Brazilian Metropolitan Area: A Time-Series Cohort Study.

IF 2.7 4区医学 Q2 HEALTH CARE SCIENCES & SERVICES Risk Management and Healthcare Policy Pub Date : 2024-06-25 eCollection Date: 2024-01-01 DOI:10.2147/RMHP.S459307

Dilson Palhares Ferreira, Claudia Vicari Bolognani, Levy Aniceto Santana, Sergio Eduardo Soares Fernandes, Matheus Serwy Fiuza de Moraes, Luana Argollo Souza Fernandes, Daniella Queiroz de Oliveira, Rosália Bezerra de Santana, Leila Bernarda Donato Gottems, Fabio Ferreira Amorim

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Abstract

Purpose: The COVID-19 pandemic posed a worldwide challenge, leading to radical changes in surgical services. The primary objective of the study was to assess the impact of COVID-19 on elective and emergency surgeries in a Brazilian metropolitan area. The secondary objective was to compare the postoperative hospital mortality before and during the pandemic.

Patients and methods: Time-series cohort study including data of all patients admitted for elective or emergency surgery at the hospitals in the Public Health System of Federal District, Brazil, between March 2018 and February 2022, using data extracted from the Hospital Information System of Brazilian Ministry of Health (SIH/DATASUS) on September 30, 2022. A causal impact analysis was used to evaluate the impact of COVID-19 on elective and emergency surgeries and hospital mortality.

Results: There were 174,473 surgeries during the study period. There was a reduction in overall (absolute effect per week: -227.5; 95% CI: -307.0 to -149.0), elective (absolute effect per week: -170.9; 95% CI: -232.8 to -112.0), and emergency (absolute effect per week: -57.7; 95% CI: -87.5 to -27.7) surgeries during the COVID-19 period. Comparing the surgeries performed before and after the COVID-19 onset, there was an increase in emergency surgeries (53.0% vs 68.8%, P < 0.001) and no significant hospital length of stay (P = 0.112). The effect of the COVID-19 pandemic on postoperative hospital mortality was not statistically significant (absolute effect per week: 2.1, 95% CI: -0.01 to 4.2).

Conclusion: Our study showed a reduction in elective and emergency surgeries during the COVID-19 pandemic, possibly due to disruptions in surgical services. These findings highlight that it is crucial to implement effective strategies to prevent the accumulation of surgical waiting lists in times of crisis and improve outcomes for surgical patients.

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COVID-19 大流行对巴西大都会地区择期手术、急诊手术和术后死亡率的影响：时间序列队列研究》。

目的：COVID-19 大流行带来了全球性的挑战，导致外科手术服务发生了翻天覆地的变化。研究的主要目的是评估 COVID-19 对巴西一个大都市地区的择期手术和急诊手术的影响。次要目标是比较大流行之前和期间的术后住院死亡率：时间序列队列研究，包括2018年3月至2022年2月期间在巴西联邦区公共卫生系统医院接受择期手术或急诊手术的所有患者的数据，使用的是2022年9月30日从巴西卫生部医院信息系统（SIH/DATASUS）中提取的数据。采用因果影响分析法评估 COVID-19 对择期手术、急诊手术和医院死亡率的影响：结果：研究期间共进行了 174,473 例手术。在 COVID-19 期间，整体手术（每周绝对影响：-227.5；95% CI：-307.0 至 -149.0）、择期手术（每周绝对影响：-170.9；95% CI：-232.8 至 -112.0）和急诊手术（每周绝对影响：-57.7；95% CI：-87.5 至 -27.7）均有所减少。比较 COVID-19 启用前后的手术情况，急诊手术有所增加（53.0% 对 68.8%，P < 0.001），住院时间没有明显缩短（P = 0.112）。COVID-19大流行对术后住院死亡率的影响没有统计学意义（每周绝对影响：2.1，95% CI：-0.01 至 4.2）：我们的研究表明，在 COVID-19 大流行期间，择期手术和急诊手术有所减少，这可能是由于手术服务中断所致。这些研究结果突出表明，在危机时期实施有效的策略以防止手术候诊名单的累积并改善手术患者的治疗效果至关重要。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Risk Management and Healthcare Policy Medicine-Public Health, Environmental and Occupational Health

CiteScore

6.20

自引率

2.90%

发文量

242

审稿时长

16 weeks

期刊介绍： Risk Management and Healthcare Policy is an international, peer-reviewed, open access journal focusing on all aspects of public health, policy and preventative measures to promote good health and improve morbidity and mortality in the population. Specific topics covered in the journal include: Public and community health Policy and law Preventative and predictive healthcare Risk and hazard management Epidemiology, detection and screening Lifestyle and diet modification Vaccination and disease transmission/modification programs Health and safety and occupational health Healthcare services provision Health literacy and education Advertising and promotion of health issues Health economic evaluations and resource management Risk Management and Healthcare Policy focuses on human interventional and observational research. The journal welcomes submitted papers covering original research, clinical and epidemiological studies, reviews and evaluations, guidelines, expert opinion and commentary, and extended reports. Case reports will only be considered if they make a valuable and original contribution to the literature. The journal does not accept study protocols, animal-based or cell line-based studies.