Impact of COVID-19 on elective surgical services in a tertiary hospital

Abstract

Introduction: The Covid-19 pandemic has affected ‘non-Covid ’patient care due to the disruption of health services globally. Sri Lanka though fortunate with low infection and mortality rates, was also affected due to safety measures taken at institutional and national level. The objective of this study wasto assess the impact of Covid 19 on different categories of elective general surgery in the main tertiary hospital of the country. Methods: This was a descriptive retrospective study. All patients who underwent elective general surgery from 1st January to 30th June 2020 were included. Data were obtained from general surgical theatre registers. Procedures were categorized according to British United Provident Association (BUPA) schedule of procedures as minor (Mn), intermediate (I), major (Mj), major plus (MP) and complex major (CM). Results: During the 6 months, 2886 patients had elective surgery with a male to female ratio of 1.21:1. The mean age was 49.8 (10 – 80) years. Table 1 and 2 indicate the total and categorized procedures respectively in the period studied. Compared to January and February, the mean reduction in surgery during the worst affected months of April and May were Mn = 90.47%, I = 92.15%, Mj = 77.65%, MP = 63.63%, CM = 11.7%. Conclusions: The sharpest reduction was observed in Mn and I category procedures. Interestingly, CM were the least impacted, followed by Mj and MP procedures. These observations indicate that a balanced strategy incorporating safety while maintaining essential elective surgical services was employed by this tertiary hospital during this period.