AB027. SOH21AS082. Patterns in presentation and management of emergency general and vascular surgical patients during the COVID-19 pandemic

Background: The global COVID-19 pandemic has impacted upon the delivery of surgical services worldwide. This study investigated the impact of the pandemic on emergency general and vascular surgical activity at a tertiary level academic teaching hospital in the Mid-West of Ireland.

Methods: Data was retrospectively sourced from the Hospital-In-Patient Enquiry (HIPE) national data collection of health and social care services from March 1st through May 31st of 2019 and 2020. The primary outcome was the difference in mean rate of weekly emergency admissions. Secondary outcomes included the rate of procedural (surgical, endoscopic or radiological intervention), rate of diagnosis-specific operative intervention, and length of stay.

Results: Records of 1,303 patients admitted acutely to general and vascular surgical on-call teams during the two study periods were reviewed. There was no significant difference in the weekly admission rate between 2019 and 2020 (mean 46.92 vs. 53.31, P=0.2791). There were similar weekly admission rates between cohorts across the top 10 diagnoses, with a significantly higher incidence of head injuries in 2020 (mean 1.85 vs. 5.23, P=0.002). The procedural intervention rate decreased from 45.3% in 2019 to 29.6% in 2020 (OR 0.51, 95% CI: 0.41–0.64). Length of stay for patients admitted in 2020 was shorter than for those in 2019 (median 3 vs. 4 days, P<0.0001)

Conclusions: In contrast to recently published data, there was no decrease in acute surgical presentations, though a significant reduction in acute procedural activity was noted. Regional healthcare planning and resource allocation for future pandemics will need to account for this.

Keywords: Admissions; COVID-19; general surgery; SARS-CoV-2; vascular