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Kastamonu Medical Journal

Kastamonu Medical Journal regularly publishes internationally qualified issues in the field of Medicine in the light of up-to-date information.

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Original Article
The impact of COVID-19 on postoperative outcomes of emergency general surgery operations
Abstract
Aims: During the pandemic due to Coronavirus disease 2019 (COVID-19) many elective operations were postponed, while emergency surgical operations inevitably continued. Emergency general surgery procedures are known to have worse outcomes compared to elective ones. Besides, it is conceivable that COVID-19 itself may worsen surgical outcomes due to it may cause respiratory distress and multi-organ dysfunction. We aimed to present patients’ data who underwent surgery due to trauma and emergency general surgery diseases during the COVID-19 pandemic and the effect of COVID-19 on surgical outcomes in this study.
Methods: Two hundred and thirty-five patients who underwent surgery due to trauma or emergency between March 2020 and January 2021 were enrolled. Two groups were created according to the COVID-19 status as positive (n=16) and negative (n=219). The demographics, clinical, laboratory, and perioperative data were analyzed and compared between these groups.
Results: The median age of the patients was 51 (18-97) years, and 144 (61.2%) of them were male. The most common diagnosis was acute appendicitis (n= 121, 51.5%) followed by ileus. Subgroup comparisons showed that the COVID-19 (+) group had more patients with comorbidity and had higher C-reactive protein values, these differences were significant (p= 0.049, p= 0.001, respectively). Open surgery was performed significantly more in the COVID-19 (+) group (p= 0.037). Serious postoperative complications and mortality were seen more in the COVID-19 (+) group, but the differences were not significant. Patients with COVID-19 had significantly longer hospital stay (p= 0.007).
Conclusion: COVID-19 positivity was found to have a negative impact on postoperative surgical outcomes in terms of emergency operations. It is not clear whether this negativity is due to the COVID-19 disease itself or the worse characteristics of patients with COVID-19.

Keywords : coronavirus, emergency surgery, pandemic

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1. Surek A, Ferahman S, Gemici E, Dural AC, Donmez T, Karabulut M.Effects of COVID-19 pandemic on general surgical emergencies: aresome emergencies really urgent? Level 1 trauma center experience. Eur JTrauma Emerg Surg. 2021;47(3):647-652.
2. Coimbra R, Edwards S, Kurihara H, et al. European Society of Traumaand Emergency Surgery (ESTES) recommendations for trauma andemergency surgery preparation during times of COVID-19 infection. EurJ Trauma Emerg Surg. 2020;46(3):505-510.
3. Gok AFK, Eryilmaz M, Ozmen MM, Alimoglu O, Ertekin C, KurtogluMH. Recommendations for Trauma and Emergency General SurgeryPractice During COVID-19 Pandemic. Ulus Travma Acil Cer Derg.2020;26(3):335-342.
4. Havens JM, Peetz AB, Do WS, et al. The excess morbidity and mortalityof emergency general surgery. J Trauma Acute Care Surg. 2015;78(2):306-311.
5. Wiersinga WJ, Rhodes A, Cheng AC, Peacock SJ, Prescott HC.Pathophysiology, transmission, diagnosis, and treatment of coronavirusdisease 2019 (COVID-19): a review. JAMA. 2020;324(8):782-793.
6. Durhan A, Şenlikçi A, Bezirci R, et al. Effect of COVID-19 pandemic onemergency general surgery and elective oncological surgery: retrospectivecross-sectional study. İzmir EAH Tıp Der. 2021;25(2):87-92
7. Ilhan B, Bozdereli Berikol G, Aydin H, Arslan Erduhan M, Dogan H.COVID-19 outbreak impact on emergency trauma visits and traumasurgery in a level 3 trauma center. Ir J Med Sci. 2022;191(5):2319-2324.
8. Copeland GP, Jones D, Walters M. POSSUM: a scoring system for surgicalaudit. Br J Surg. 1991;78(3):355-360.
9. Yadav K, Singh M, Griwan M, Mishra T, Kumar N, Kumar H. Evaluationof POSSUM and P-POSSUM as a tool for prediction of surgical outcomesin the Indian population. Australas Med J. 2011;4(7):366-373.
10. Dindo D, Demartines N, Clavien PA. Classification of surgicalcomplications: a new proposal with evaluation in a cohort of 6336 patientsand results of a survey. Ann Surg. 2004;240(2):205-213.
11. Borges do Nascimento IJ, Cacic N, Abdulazeem HM, et al. Novelcoronavirus infection (COVID-19) in humans: a scoping review andmeta-analysis. J Clin Med. 2020;9(4):941.
12. Sah P, Fitzpatrick MC, Zimmer CF, et al. Asymptomatic SARS-CoV-2infection: a systematic review and meta-analysis. Proc Natl Acad Sci.2021;118(34):e2109229118.
13. Ai T, Yang Z, Hou H, et al. Correlation of chest ct and rt-pcr testing forcoronavirus disease 2019 (COVID-19) in China: a report of 1014 cases.Radiology. 2020;296(2):E32-E40.
14. De Simone B, Chouillard E, Di Saverio S, et al. Emergency surgery duringthe COVID-19 pandemic: what you need to know for practice. Ann R CollSurg Engl. 2020;102(5):323-332.
15. Osorio J, Madrazo Z, Videla S, et al. Analysis of outcomes of emergencygeneral and gastrointestinal surgery during the COVID-19 pandemic. Br JSurg. 2021;108(12):1438-1447.
16. de Bock E, Filipe MD, Pronk A, et al. Factors affecting 30-day postoperativecomplications after emergency surgery during the COVID-19 outbreak: Amulticentre cohort study. Int J Surg Open. 2021;35:100397.
17. Jonker PKC, van der Plas WY, Steinkamp PJ, et al. Perioperative SARS-CoV-2 infections increase mortality, pulmonary complications, andthromboembolic events: A Dutch, multicenter, matched-cohort clinicalstudy. Surgery. 2021;169(2):264-274.
18. Zhao N, Wu L, Cheng Y, et al. The effect of emergency surgery onacute abdomen patients with COVID-19 pneumonia: a retrospectiveobservational study. Aging (Albany NY). 2020;12(15):15771-15783.
Article available in :
Volume 3, Issue 3, 2023
Page : 150-154
https://doi.org/10.51271/KMJ-0116
Article Information
Received : 03 Ağu 2023
Accepted : 25 Ağu 2023
Published : 22 Eyl 2023
Corresponding Author :

Yusuf Murat Bag: Department of General Surgery, Tayfur Ata Sökmen Faculty of Medicine, Mustafa Kemal University, Hatay, Turkey

[email protected]
Citation : Barut B, Bag YM. The impact of COVID-19 on postoperative outcomes of emergency general surgery operations. Kastamonu Med J. 2023;3(3):150-154.

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