Are there benefits to maintaining Covid-19 pandemic pathways for the long-term? A surgical assessment unit based study
- Resource Type
- Authors
- Dilhara Karunaratne; Hannah Brooke-Ball; Matthew.T.V. Miller; Naomi Simone Laskar; Alexander Hunt
- Source
- The Surgeon
- Subject
- Adult
Male
general surgery
medicine.medical_specialty
Coronavirus disease 2019 (COVID-19)
surgical assessment unit
030230 surgery
Patient Readmission
Article
Unit (housing)
03 medical and health sciences
0302 clinical medicine
Primary outcome
Pandemic
Outcome Assessment, Health Care
Medicine
Humans
Hospital Mortality
Aged
Retrospective Studies
business.industry
pandemic
Patient Selection
COVID-19
030208 emergency & critical care medicine
Length of Stay
Middle Aged
Term (time)
Clinical Practice
Survival Rate
Sample size determination
Surgical Procedures, Operative
Emergency medicine
Critical Pathways
Surgery
Female
business
Cohort study
- Language
- ISSN
- 1479-666X
Background The Covid-19 pandemic has led to the introduction of conservative non-operative approaches to surgical management favouring community driven care. The aim of this study was to determine the effect of these pathways on patients attending a surgical assessment unit (SAU). Method This was a retrospective observational cohort study. We included all consecutive attendances to the SAU in April 2020 (Covid-19 period) and April 2019 (pre-Covid-19). The Covid-19 period saw a shift in clinical practice towards a more conservative approach to the management of acute surgical presentations. The primary outcome measure was 30-day readmission. The secondary outcome measures were length of hospital stay, inpatient investigations undertaken and 30-day mortality. Results A total of 451 patients were included. This represented 277 and 174 attendances in pre-Covid-19, and Covid-19 groups respectively. The rates of unplanned 30-day readmission rates in the Covid-19 and pre-Covid-19 periods were 16.7% and 12.6% respectively (P=0.232). There were significantly fewer planned follow-ups in the Covid-19 (36.2%) compared to the pre-Covid-19 group (49.1%; P
Highlights • Covid-19 has led to considerable adaptations in surgical management • This study compared patient outcomes during pre-Covid-19 and Covid-19 eras • There were far fewer investigations and planned follow ups during the Covid-19 era • There was no difference in length of hospital stay, readmission or mortality rates • Covid-19 resource efficient approaches can potentially be continued long term