Acute Care Surgery Service Is Essential During a Nonsurgical Catastrophic Event, the COVID-19 Pandemic
| Autor: | Janis L. Breeze, Sharon Holewinski, Horacio Hojman, Sandra S. Arabian, Benjamin P Johnson, Stanley A. Nasraway, Nikolay Bugaev |
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| Rok vydání: | 2020 |
| Předmět: |
2019-20 coronavirus outbreak
medicine.medical_specialty Critical Care Coronavirus disease 2019 (COVID-19) Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) acute care surgery service COVID-19 pandemic 030230 surgery Article Tertiary Care Centers 03 medical and health sciences Hospitals Urban 0302 clinical medicine Pandemic medicine Humans Acute care surgery Pandemics Retrospective Studies Service (business) Academic Medical Centers Retrospective review SARS-CoV-2 business.industry COVID-19 030208 emergency & critical care medicine General Medicine Emergency medicine Wounds and Injuries Emergency Service Hospital business Surgery Department Hospital |
| Zdroj: | The American Surgeon |
| ISSN: | 1555-9823 0003-1348 |
| Popis: | BackgroundThe role of an acute care surgery (ACS) service during the COVID-19 pandemic is not well established.MethodsA retrospective review of the ACS service performance in an urban tertiary academic medical center. The study was performed between January and May 2020. The demographics, clinical characteristics, and outcomes of patients treated by the ACS service 2 months prior to the COVID surge (pre-COVID group) and during the first 2 months of the COVID-19 pandemic (surge group) were compared.ResultsTrauma and emergency general surgery volumes decreased during the surge by 38% and 57%, respectively; but there was a 64% increase in critically ill patients. The proportion of patients in the Department of Surgery treated by the ACS service increased from 40% pre-COVID to 67% during the surge. The ACS service performed 32% and 57% of all surgical cases in the Department of Surgery during the pre-COVID and surge periods, respectively. The ACS service managed 23% of all critically ill patients in the institution during the surge. Critically ill patients with and without confirmed COVID-19 infection treated by ACS and non-ACS intensive care units during the surge did not differ in demographics, indicators of clinical severity, or hospital mortality:13.4% vs. 13.5% ( P = .99) for all critically ill patients; and 13.9% vs. 27.4% ( P = .12) for COVID-19 critically ill patients.ConclusionAcute care surgery is an “essential” service during the COVID-19 pandemic, capable of managing critically ill nonsurgical patients while maintaining the provision of trauma and emergent surgical services.Level of EvidenceIII.Study TypeTherapeutic. |
| Databáze: | OpenAIRE |
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