Impact of COVID-19 on emergency surgical patients, surgical services

Editor's Note

This study from the UK of surgical patients in 18 countries finds that the first wave of the COVID-19 pandemic significantly impacted surgical patients—directly through comorbid infections and indirectly by increasing mortality—irrespective of their COVID-19 status.

In a subgroup analysis of 3,176 adult emergency surgical patients, all-cause, in-hospital mortality was 3.6%, compared with 15.5% for those with COVID-19.

Higher Clinical Frailty Scale scores >7, American Society of Anesthesiologists grade >2, and COVID-19 infection were independently linked to significantly increased in-hospital mortality.

The peak months (March to May) of the first wave were independently associated with significantly higher in-hospital mortality, compared with nonpeak months.

During the study, operating room capacity decreased by a mean of 63.6%, and surgical staffing decreased by 27.3%.

The findings show it is imperative that both emergency and elective surgical services be maintained to ensure patient safety and that accurate patient risk stratification occurs using patient frailty assessment scores, the authors say.