Impact of Covid-19 on emergency 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. In Sri Lanka, safety measures were taken at institutional and national level to curtail elective health facilities though emergency services continued. The objective of this study was to assess the impact of Covid 19 on emergency general surgical (eGS) trauma and non-trauma procedures in the main tertiary hospital of the country. Methods: This was a descriptive, retrospective study. All patients who underwent eGS (trauma & non- trauma) from 1st January to 30th June 2020 were included. Data were collected from registers of the accident service and casualty surgical theatres. Results: During the 6 months, 7034 eGS procedures were performed with a male: female ratio of 1.85:1 and a mean age of 53.4 (16-88)) years. Table 1 and 2 illustrate the total number of trauma and non-trauma emergency eGS procedures during this period. Compared to the first 3 months of 2020, the mean percentage fall in trauma and non-trauma eGS for the worst affected month of April was 52.64% and 41.32% respectively. Comparing February to April, the overall reduction in minor-intermediate and major-complex major eGS categories was 35.7% and 37.3% respectively. Conclusion: eGS trauma procedures dropped by more than half in the worst affected month of April but rapidly returned to previous levels with the easing of the lockdown in May. The fall in non- trauma eGS was less pronounced and but showed a slower return to normality. The reduction was uniform across all categories of eGS.