Abstract
Background: The SARS-CoV-2 pandemic is still ongoing and a major challenge for health care services worldwide. In the first WSES COVID-19 emergency surgery survey, a strong negative impact on emergency surgery (ES) had been described already early in the pandemic situation. However, the knowledge is limited about current effects of the pandemic on patient flow through emergency rooms, daily routine and decision making in ES as well as their changes over time during the last two pandemic years. This second WSES COVID-19 emergency surgery survey investigates the impact of the SARS-CoV-2 pandemic on ES during the course of the pandemic. Methods: A web survey had been distributed to medical specialists in ES during a four-week period from January 2022, investigating the impact of the pandemic on patients and septic diseases both requiring ES, structural problems due to the pandemic and time-to-intervention in ES routine. Results: 367 collaborators from 59 countries responded to the survey. The majority indicated that the pandemic still significantly impacts on treatment and outcome of surgical emergency patients (83.1% and 78.5%, respectively). As reasons, the collaborators reported decreased case load in ES (44.7%), but patients presenting with more prolonged and severe diseases, especially concerning perforated appendicitis (62.1%) and diverticulitis (57.5%). Otherwise, approximately 50% of the participants still observe a delay in time-to-intervention in ES compared with the situation before the pandemic. Relevant causes leading to enlarged time-to-intervention in ES during the pandemic are persistent problems with in-hospital logistics, lacks in medical staff as well as operating room and intensive care capacities during the pandemic. This leads not only to the need for triage or transferring of ES patients to other hospitals, reported by 64.0% and 48.8% of the collaborators, respectively, but also to paradigm shifts in treatment modalities to non-operative approaches reported by 67.3% of the participants, especially in uncomplicated appendicitis, cholecystitis and multiple-recurrent diverticulitis. Conclusions: The SARS-CoV-2 pandemic still significantly impacts on care and outcome of patients in ES. Well-known problems with in-hospital logistics are not sufficiently resolved by now; however, medical staff shortages and reduced capacities have been dramatically aggravated over last two pandemic years.
| Original language | English |
|---|---|
| Article number | 34 |
| Journal | World Journal of Emergency Surgery |
| Volume | 17 |
| Issue number | 1 |
| DOIs | |
| Publication status | Published - Dec 2022 |
Keywords
- Appendicitis
- COVID-19
- Capacity
- Emergency
- Emergency surgery
- Pandemic
- Quarantine
- SARS-CoV-2
- Time to intervention
- WSES
ASJC Scopus subject areas
- Surgery
- Emergency Medicine
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In: World Journal of Emergency Surgery, Vol. 17, No. 1, 34, 12.2022.
Research output: Contribution to journal › Article › peer-review
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TY - JOUR
T1 - Two years later
T2 - Is the SARS-CoV-2 pandemic still having an impact on emergency surgery? An international cross-sectional survey among WSES members
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N1 - Funding Information: The authors sincerely thank all collaborators of the study for participation in the survey. The WSES COVID-19 emergency surgery survey collaboration group (only those who agree are listed as collaborators) Adam Peckham-Cooper, Leeds Teaching Hospitals NHS Trust, United Kingdom Adrian Camacho-Ortiz, Hospital Epidemiology and Infectious diseases, Hospital Universitario Dr. José Eleuterio Gonzalez, Monterrey, Mexico Aikaterini T. Mastoraki, National and Kapodistrian University of Athens, Laikon Hospital, Greece Aitor Landaluce-Olavarria, Alfredo Espinosa Urduliz Hospital, Spain Ajay Kumar Pal, King George's Medical University, India Akira Kuriyama, Kurashiki Central Hospital, Japan Alain Chichom-Mefire, Faculty of Health Sciences, University of Buea, Cameroon Alberto Porcu, Università degli Studi di Sassari, Italy Aleix Martínez-Pérez, Department of General and Digestive Surgery, Hospital Universitario Doctor Peset, Valencia, Spain Aleksandar R. Karamarkovic, Surgical Clinic "Nikola Spasic" - UCC Zvezdara Belgrade, Faculty of Medicine University of Belgrade, Serbia Aleksei V. Osipov, Department of urgent surgery, Scientific research institute of emergency medicine, Saint-Petersburg, Russia Alessandro Coppola, General Surgery, Fondazione Policlinico Universitario Campus Bio-Medico, Italy Alessandro Cucchetti, Department of Medical and Surgical Sciences - DIMEC; University of Bologna, Italy Alessandro Spolini, UOC Chirurgia Generale Sondrio ASST Valtellina-Alto Lario, Italy Alessio Giordano, General Surgery unit, Nuovo Ospedale S. Stefano, Prato, Italy Alexander Reinisch-Liese, Department of General, Viszeral and Oncologic Surgery, Klinikum Wetzlar,Teaching Hospital of JLU Giessen, Wetzlar, Germany Alfie J. Kavalakat, Jubilee Mission Medical College & RI, Thrissur, India Alin Vasilescu, Department of Surgery, St Spiridon University Hospital, “Grigore T Popa” University of Medicine and Pharmacy, Iasi, Romania Amin Alamin, General surgery department, Ealing Hospital, London North West University Healthcare NHS Trust, United Kingdom Amit Gupta, Department of Surgery, All India Institute of Medical Sciences Rishikesh, Rishikesh, India Ana Maria Dascalu, Faculty of Medicine, Carol Davila University of Medicine and Pharmacy Bucharest, Romania Ana-Maria Musina, University of Medicine and Pharmacy Grigore T. Popa Iasi/ Regional Institute of Oncology Iasi, Romania Anargyros Bakopoulos, Department of Surgery, Attikon University Hospital, University of Athens, Athens, Greece Andee Dzulkarnaen Zakaria, Department of Surgery, School of Medical Sciences & Hospital USM, Universiti Sains Malaysia, Malaysia Andras Vereczkei, Department of Surgery, Medical Center, University of Pécs, Hungary Andrea Balla, UOC of General and Minimally Invasive Surgery, Hospital “San Paolo”, Largo Donatori del Sangue 1, Civitavecchia, Rome, Italy Andrea Bottari, Chirurgia dell'Apparato Digerente, Azienda Ospedaliero-Universitaria Careggi, Firenze, Italy Andreas Baumann, Neurosurgical Department, Cologne Merheim Medical Center, Universitiy of Witten Herdecke, Germany Andreas Fette, PS_SS, Weissach im Tal, Germany Andrey Litvin, Immanuel Kant Baltic Federal University, Regional Clinical Hospital, Kaliningrad, Russia Aniella Katharina Reichert, Department of Gynaecology and Obstetrics, University Hospital of Giessen, Giessen, Germany Anna Guariniello, Emergency Surgery Ravenna Hospital, Italy Anna Paspala, Evgenideio Hospital, Athens, Greece Anne-Sophie Schneck, Centre Hospitalier Universitaire de la Guadeloupe, Guadeloupe Antonio Brillantino, Emergency Surgery Department, "A. Cardarelli" hospital, via Cardarelli 9, 80131 Naples, Italy Antonio Pesce, AUSL of Ferrara - University of Ferrara, Italy Arda Isik, Istanbul medeniyet university, Turkey Ari Kalevi Leppäniemi, Helsinki University Hospital and University of Helsinki, Finland Aristeidis Papadopoulos, General Hospital of Nikaia, Greece Aristotelis Kechagias, Department of General Surgery, Kanta-Häme Central Hospital, Finland Ashraf yehya abdalla Mohamed, General Surgery Department, Buraimi Hospital, Buraimi, Oman Ashrarur Rahman Mitul, Bangladesh Shishu Hospital & Institute, Bangladesh Athanasios Marinis, Third Department of Surgery, Tzaneio General Hospital, Piraeus, Greece Athanasios Syllaios, Laiko General Hospital, Greece Baris Mantoglu, Sakarya Medical Faculty, Turkey Belinda De Simone, Department of Emergency, digestive and metabolic minimally invasive surgery, Poissy and Saint Germain en Laye Hospitals, France Benjamin Stefan Weiss, Department for Adult and Pediatric Cardiovascular Surgery, University Hospital of Giessen, Giessen, Germany Bernd Pösentrup, Department of Pediatric Surgery and Pediatric Urology, Children´s Hospital, Klinikum Dortmund, Dortmund, Germany Biagio Picardi, San Filippo Neri ASL Roma 1, Italy Biagio Zampogna, Department of Orthopaedic and Trauma Surgery, Campus Bio-Medico University of Rome, Rome, Italy Boris Eugeniev Sakakushev, Research Institute at Medical University of Plovdiv, Medical University of Plovdiv, Department of Surgical Propedeutics, Section of General Surgery, UMHAT St George Plovdiv, First Clinic of General Surgery, Bulgaria Boyko Chavdarov Atanasov, Umhat Eurohospital, Medical university of Plovdiv, Bulgaria Bruno Nardo, Annunziata Hospital, Unversity of Calabria, Italy Bulent Calik, University of Healthy Sciences Izmir Bozyaka Education and Research Hospital, General Surgery Department, Turkey Camilla Cremonini, Pisa university hospital, Italy Carlos A. Ordoñez, Division of Trauma and Acute Care Surgery, Department of Surgery, Fundacion Valle del Lili, Cali, Colombia Charalampos Seretis, General University Hospital of Patras, Greece Chiara Cascone, Fondazione Policlinico Campus Bio-Medico di Roma, Italy Christos Chouliaras, 1st Department of Surgery, General Hospital of Nikaia, Piraeus, Greece Cino Bendinelli, John Hunter Hospital. Newcastle, NSW, Australia Claudia Lopes, Hospital Universitario Donostia-Osakidetza, Spain Claudio Guerci, Ospedale Luigi Sacco, Italy Clemens Weber, Department of Neurosurgery, Stavanger University Hospital, Norway Constantinos Nastos, Attikon University Hospital, Greece Cristian Mesina, Emergency County Hospital of Craiova, Romania Damiano Caputo, Department of Surgery University Campus Bio-Medico di Roma, Fondazione Policlinico Universitario Campus Bio-Medico, Italy Damien Massalou, Acute care surgery, University Hospital of Nice, Centre Hospitalier Universitaire de Nice, Nice, France Davide Cavaliere, Department of Surgery, Forlì Hospital - AUSL della Romagna, Italy Deborah A McNamara, RCSI University of Medicine and Health Sciences, Ireland Demetrios Demetriades, USC School of Medicine, Los Angeles, United States Desirè Pantalone, Department of Experimental and Clinical Medicine University of Florence, University Hospital Careggi, Florence, Italy Diego Coletta, AO Ospedali Riuniti Marche Nord, Department of General Surgery, Italy Diego Sasia, General and Oncological Surgery Unit, Santa Croce and Carle Hospital, Cuneo, Italy Diego Visconti, Chirurgia Generals d´Urgenza e PS, AOU Cittá della Salute e della Scienza, Turin, Italy Dieter G. Weber, Department of General Surgery, Royal Perth Hospital & The University of Western Australia, Australia Diletta Corallino, Department of General Surgery and Surgical Specialities „Paride Stefanini“, Sapienza, University of Rome, Italy Dimitrios Chatzipetris, Department of Surgery, Metaxa Cancer Hospital, Piraeus, Greece Dimitrios K. Manatakis, Department of Surgery, Athens Naval and Veterans Hospital, Athens, Greece Dimitrios Ntourakis, School of Medicine, Division of Surgery, European University Cyprus, Greece Dimitrios Papaconstantinou, Attikon University Hospital, 3rd Department of Surgery, Greece Dimitrios Schizas, First Department of Surgery, National and Kapodistrian University of Athens, Athens, Greece Dimosthenis Chrysikos, First Department of Propaedeutic Surgery, Hippocration Hospital, School of Medicine, University of Athens, Athens, Greece Dmitry Mikhailovich Adamovich, Department of Surgical Diseases II, Gomel State Medical University, Gomel, Belarus Doaa Elkafrawy, Kafersaad general hospital, Egypt Dragos Seban, University of Medicine and Pharmacy, Carol Davila Bucharest & 4th Surgery Department of University Emergency Hospital Bucharest, Bucharest, Romania Edgar Fernando Hernández García, Cirugía de trauma, Hospital Central Militar, Ciudad de México, Mexico Edoardo Baldini, Ospedale Santa Maria delle Stelle, Melzo, Italy Edoardo Picetti, Department of Anesthesia and Intensive Care, Parma University Hospital, Parma, Italy Edward C.T.H. Tan, Radboud university medical center, Department of Surgery, Netherlands Efstratia Baili, Guy's and St Thomas' NHS Foundation Trust, United Kingdom Eftychios Lostoridis, Kavala General Hospital, Kavala, Greece Elena Adelina Toma, Surgery Department, UMF Carol Davila Bucharest, Romania Elif Colak, University of Samsun, Turkey Elisabetta Cerutti, Department of Anesthesia and Transplant Surgical Intensive care, Ospedali Riuniti, Ancona, Italy Elmin Steyn, Stellenbosch University and Tygerberg Hospital, South Africa Elmuiz A. Hsabo, Manchester University NHS Foundation Trust, United Kingdom Emmanouil Ioannis Kapetanakis, Department of Thoracic Surgery, “Attikon” University Hospital, National and Kapodistrian University of Athens, Athens, Greece Emmanouil Kaouras, Department of Surgery, Metaxa Cancer Hospital, Piraeus, Greece Emmanuel Schneck, Department of Anesthesiology, Operative Intensive Care Medicine and Pain Therapy, University Hospital of Giessen, Rudolf-Buchheim-Strasse 7, Giessen, Germany Emrah Akin, Sakarya University Faculty of Medicine, Turkey Emre Gonullu, General Surgery, Sakarya training and research hospital, Sakarya, Turkey Enes çelik, Derik State Hospital, Turkey Enrico Cicuttin, General, Emergency and Trauma Surgery, Pisa University Hospital, Pisa, Italy Enrico Pinotti, Policlinico San Pietro, Italy Erik Johnsson, Department of Surgery, Sahlgren University Hospital, Gothenburg, Sweden Ernest E. Moore, Director of Research Ernest E Moore Shock Trauma Center at Denver Health, United States Ervis Agastra, Regional Hospital of Korce, Albania Evgeni Nikolaev Dimitrov, Department of Surgical Diseases, University Hospital "Prof. Dr. Stoyan Kirkovich" Stara Zagora, Bulgaria Ewen A Griffiths, Department of Upper GI Surgery, Queen Elizabeth Hospital, Birmingham, United Kingdom Fabrizio D'Acapito, Morgagni-Pierantoni Hospital, AUSL Romagna, Italy Federica Saraceno, UOC of General and Minimally Invasive Surgery, Hospital „San Paolo“, Largo Donatori del Sangue 1, Civitavecchia, Rome, Italy Felipe Alconchel, Virgen de la Arrixaca University Hospital (IMIB-Arrixaca), Spain Felix Alexander Zeppernick, Department of Gynaecology and Obstetrics, University Hospital of Giessen, Giessen, Germany Fernando Machado Rodríguez, Departamento de Emergencia, Hospital de Clínicas „Dr. Manuel Quintela“ - Facutad de Medicina de la UdelaR, Montevideo, Uruguay Fikri Abu-Zidan, Department of Surgery, College of Medicine, UAE University, Al-Ain, United Arab Emirates Francesca Pecchini, Division of General Surgery, Emergency and New Technologies, Ospedale Civile Baggiovara, AOU, Modena, Italy Francesco Favi, UOC Chirurgia Generale e DÚrgenza Cesena Ausl della Romagna, Italy Francesco Ferrara, Department of Surgery, San Carlo Borromeo Hospital, ASST Santi Paolo e Carlo, Milan, Italy Francesco Fleres, Department of Human Pathology of the Adult and Evolutive Age “Gaetano Barresi”, Section of General and Emergency Surgery, University of Messina, Messina, Italy Francesco Pata, Department of Surgery, Nicola Giannettasio Hospital, Corigliano-Rossano, Italy Francesco Pietro Maria Roscio, ASST Valle Olona Busto Arsizio, Italy Francesk Mulita, Department of Surgery, General University Hospital of Patras, Greece Frank J. M. F. Dor, 1. Imperial College Renal and Transplant Centre, Hammersmith Hospital, Imperial College Healthcare NHS Trust, London, 2. Department of Surgery and Cancer, Imperial College, London, United Kingdom Fredrik Linder, Department of Surgical Sciences, Emergency Surgery, Uppsala University, Uppsala, Sweden Gabriel Dimofte, Institutul Regional de Oncologie Iasi, Universitatea de Medicina si Farmacie „Grigore T. Popa“ Iasi, Romania Gabriel Rodrigues, General Surgery, Kasturba Medical College Hospital, Manipal Academy of Higher Education, Manipal, India Gabriela Nita, Sant'Anna Hospital, AUSL Reggio Emilia, Italy Gabriele Sganga, Emergency Surgery & Trauma, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy Gennaro Martines, Azienda Ospedaliero Universitaria Policlinico Bari, Italy Gennaro Mazzarella, Department of Emergency Surgery, Sapienza University of Rome, Rome, Italy Gennaro Perrone, Department of emergency surgery, Parma Maggiore Hospital, Parma, Italy George Velmahos, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA Georgios D. Lianos, Department of Surgery, University Hospital of Ioannina, Greece Gia Tomadze, Surgery Department of Tbilisi State Medical University, Georgia Gian Luca Baiocchi, UOC General Surgery, ASST Cremona; Department of Clinical and Experimental Sciences, University of Brescia, Italy Giancarlo D'Ambrosio, Policlinico Umberto I, Univeristà La Sapienza, Roma, Italy Gianluca Pellino, Department of Advanced Medical and Surgical Sciences, Università degli Studi della Campania Luigi Vanvitelli, Naples, Italy Gianmaria Casoni Pattacini, Division of General Surgery, Emergency and New Technologies, Ospedale Civile Baggiovara, AOU, Modena, Italy Giorgio Giraudo, Department of Surgery ASO Santa Croce e Carle Cuneo, Italy Giorgio Lisi, Department of Surgery, Sant'Eugenio Hospital, piazzale dell'umanesimo 10, Rome, Italy Giovanni Domenico Tebala, Oxford University Hospitals NHS Foundation Trust, United Kingdom Giovanni Pirozzolo, Ospedale dell'Angelo - ULSS3 Serenissima – Venice, Italy Giulia Montori, General surgery, Vittorio Veneto hospital (TV), Italy Giulio Argenio, UOC Chirurgia Generale ed Oncologica, AO San Pio, Benevento, Italy Giuseppe Brisinda, Department of Surgery, Fondazione Policlinico Universitario A Gemelli IRCCS and Università Cattolica S. Cuore, Rome, Italy Giuseppe Currò, AOU Mater Domini Catanzaro - Magna Graecia University of Catanzaro, Italy Giuseppe Giuliani, Department of general and emergency surgery, Misericordia Hospital, Grosseto, Italy Giuseppe Palomba, Università degli Studi di Napoli Federico II, Italy Giuseppe Roscitano, University of Catania, Italy Gökhan Avşar, Ankara university faculty of medicine department of surgical oncology, Turkey Goran Augustin, University Hospital Centre Zagreb, Croatia Guglielmo Clarizia, UOC Chirurgia Generale, PO Sondrio, ASST Valtellina e Alto Lario, Italy Gustavo M. Machain Vega, University of Asuncion, Faculty of Medical Sciences, II Chair and Service of General Surgery Hospital de Clinicas FCM, Paraguay Gustavo P. Fraga, Division of Trauma Surgery, University of Campinas (Unicamp), Brazil Harsheet Sethi, Acute Surgical Unit, Princess Alexandra Hospital, Brisbane, QLD, Australia Hazim Abdulnassir Eltyeb, General Surgery, Health Education North East, United Kingdom Helmut A. Segovia Lohse, II Cátedra de Clínica Quirúrgica. Hospital de Clínicas. Universidad Nacional de Asunción. San Lorenzo, Paraguay Herald René Segovia Lohse, II Cátedra de Clínica Quirúrgica, Hospital de Clínicas, Universidad Nacional de Asunción, San Lorenzo, Paraguay Hüseyin Bayhan, Mardin Training and Research Hospital, Turkey Hytham K. S. Hamid, Kuwaiti Specialized Hospital, Sudan Igor A. Kryvoruchko, Kharkiv National Medical University, Ukraine Immacolata Iannone, Azienda Ospedaliera Policlinico Umberto I, Roma, Italy Imtiaz Wani, Govt Gousia Hospital, Srinagar, India Ioannis I. Lazaridis, Clarunis, Department of Visceral Surgery, University Centre for Gastrointestinal and Liver Diseases, St. Clara Hospital and University Hospital Basel, Basel, Switzerland Ioannis Katsaros, Department of Surgery, Metaxa Cancer Hospital, Pireaus, Greece Ioannis Nikolopoulos, Lewisham & Greenwich NHS Trust, United Kingdom Ionut Negoi, Carol Davila University of Medicine and Pharmacy Bucharest, Emergency Hospital of Bucharest, Romania Isabella Reccia, Department of Surgery and Cancer, Hammersmith Hospital, Imerpial College Healthcare NHS Trust, London, United Kingdom Isidoro Di Carlo, University of Catania, Italy Iyiade Olatunde Olaoye, Surgery Department, University of Ilorin Teaching Hospital, Ilorin, Nigeria Jacek Czepiel, Department of Infectious and Tropical Diseases, Jagiellonian University Medical College, Krakow, Poland Jae Il Kim, Department of Surgery, Inje University Ilsan Paik Hospital, Goyang, South Korea Jeremy Meyer, University Hospitals of Geneva, Geneva, Switzerland Jesus Manuel Saenz Terrazas, Senior Surgeon for the International Committee of the Red Cross, Nigeria Joel Noutakdie Tochie, Anaesthesiologist and Intensive Care Physician, Laquintinie Hospital of Douala, Douala, Cameroon Joseph M. Galante, University of California, Davis, United States Justin Davies, Cambridge University Hospitals NHS Foundation Trust, United Kingdom Kapil Sugand, Imperial College London, United Kingdom Kebebe Bekele Gonfa, Maddawalabu University Goba Referral Hospital, Ethiopia Kemal Rasa, Anadolu Medical Center Hospital affiliated with Johns Hopkins Hospital, Kocaeli, Turkey Kenneth Y. Y. Kok, Pengiran Anak Puteri Rashidah Saadatul Bolkiah Institue of Health Sciences, Universiti Brunei darussalam, Brunei Konstantinos G. Apostolou, 1st Department of Surgery, National and Kapodistrian University of Athens, Laiko General Hospital, Athens, Greece Konstantinos Lasithiotakis, Department of Surgery, University Hospital of Heraklion, Crete, Greece Konstantinos Tsekouras, Sismanogleio General Hospital, Athens, Greece Kumar Angamuthu, Department of Clinical Microbiology, Infection Prevention & Control, Almana General Hospital, Dammam, Saudi Arabia Lali Akhmeteli, Tbilisi State Medical University, Georgia Larysa Sydorchuk, Bukovinian State Medical University, Ukraine Laura Fortuna, General Surgery, Azienda Ospedaliero-Universitaria Careggi (AOUC), Largo Giovanni Alessandro Brambilla, Firenze (FI), Italy Leandro Siragusa, Department of Surgery, Università degli studi di Roma Tor Vergata, Italy Leonardo Pagani, Antimicrobial Stewardship Program, Infectious Diseases Branch, Bolzano Central Hospital, Italy Leonardo Solaini, Department of Medical and Surgical Sciences, University of Bologna, Morgagni Pierantoni Hospital, Forlì, Italy Lisa A. Miller, Western Michigan University Homer Stryker, MD School of Medicine, United States Lovenish Bains, Maulana Azad Medical College, New Delhi, India Luca Ansaloni, San Matteo Hospital, Pavia, Italy Luca Ferrario, General Surgery Trauma Team ASST-GOM Niguarda, Milan, Italy Luigi Bonavina, Department of Biomedical Sciences for Health, IRCCS Policlinico San Donato, Division of General and Foregut Surgery, University of Milan, Italy Luigi Conti, Acute care Surgery Unit , Department of Surgery, AUSL Piacenza, Italy Luis Antonio Buonomo, Hospital Zonal de Agudos "Dr. Alberto Balestrini", Argentina Luis Tallon-Aguilar, Virgen del Rocío University Hospital, Spain Lukas Tomczyk, Department of general and visceral surgery, General Hospital Lich, Germany Lukas Werner Widmer, Department of Visceral Surgery and Medicine, University Hospital of Bern, Bern, Switzerland Maciej Walędziak, Military Institute of Medicine, Department of General Surgery, Poland Mahir Gachabayov, Vladimir City Emergency Hospital, Russia Maloni Bulanauca, Department of Surgery, Labasa Hospital, Fiji Manu L.N.G. Malbrain, Intensive Care Medicine, International Fluid Academy, Lovenjoel, Belgium and First Department of Anaesthesiology and Intensive Therapy, Medical University of Lubin, Poland Marc Maegele, Department for Trauma and Orthopedic Surgery, Cologne-Merheim Medical Center (CMMC), Institute for Research in Operative Medicine (IFOM), University Witten-Herdecke (UW/H), Campus Cologne-Merheim, Ostmerheimerstr. 200, Cologne, Germany Marco Catarci, Ospedale Sandro Pertini, Roma, Italy Marco Ceresoli, University of Milano-Bicocca, Italy Maria Chiara Ranucci, Azienda ospedaliera Santa Maria di Terni, Italy Maria Ioanna Antonopoulou, Naval and Veteran Hospital of Crete, Greece Maria Papadoliopoulou, General University Hospital Attikon, Athens, Greece Maria Rosaria Valenti, Policlinico di Catania, Italy Maria Sotiropoulou, Evaggelismos General Hospital, Greece Mario D'Oria, Division of Vascular and Endovascular Surgery, Cardiovascular Department, University Hospital of Trieste ASUGI, Italy Mario Serradilla Martín, Instituto de Investigación Sanitaria Aragón, Department of Surgery, Miguel Servet University Hospital, Zaragoza, Spain Markus Hirschburger, Department of General, Visceral and Thoracic Surgery, Hospital of Worms, Worms, Germany Massimiliano Veroux, General Surgery, University Hospital of Catania, Department of Medical and Surgical Sciences and Advanced Technologies, University of Catania, Italy Massimo Fantoni, Fondazione Policlinico Gemelli IRCCS - UNiversità Cattolica S. Cuore, Italy Matteo Nardi, San Camillo Forlanini Hospital, Italy Matti Tolonen, HUS Abdominal Center, Helsinki University Hospital and University of Helsinki, Finland Mauro Montuori, Policlinico San Pietro - Department of Surgery - Via Carlo Forlanini 15 Ponte San Pietro, Italy Mauro Podda, Department of Surgical Science, University of Cagliari, Cagliari, Italy Maximilian Scheiterle, SOD Chirurgia d'Urgenza, Careggi, Italy Maximos Frountzas, First Propaedeutic Department of Surgery, National and Kapodistrian University of Athens, Medical School, Hippocration General Hospital of Athens, Greece Mehmet Sarıkaya, Mardin, Turkey Mehmet Yildirim, University of Health Sciences İzmir Bozyaka Training and Research Hospital General Surgery Department, Turkey Michael Bender, Department of Neurosurgery, University Hospital of Giessen, Germany Michail Vailas, Laiko General hospital Athens, Greece Michel Teuben, Cantonal Hospital Frauenfeld, Switzerland Michela Campanelli, Emergency Surgery Unit, University Hospital of Tor Vergata, viale Oxford 81, Rome, Italy Michele Ammendola, Health of Science Department, "Magna Graecia" University Medical School, Digestive Surgery Unit, "Mater Domini" Hospital, Catanzaro, Italy Michele Malerba, Surgical Department ASL2 Savonese, Santa Corona Hospital, Pietra Ligure (SV), Italy Michele Pisano, ASST Papa Giovanni Bergamo, Italy Mihaela Pertea, Sf Spiridon Emegency Hospital Iasi, University of Medicine and Pharmacy "Grigore T Popa"Iasi, Romania Mihail Slavchev, University Hospital Eurohospital, Plovdiv, Bulgaria Mika Ukkonen, Tampere University Hospital, Finland Miklosh Bala, Department of General Surgery, Hadassah Medical Center and Faculty of Medicine, Hebrew University of Jerusalem, Israel Mircea Chirica, Service de chirurgie digestive, Centre hospitalier universitaire Grenoble Alpes, France Mirko Barone, Department of Surgery, SS. Annunziata University Hospital of Chieti, Italy Mohamed Maher Shaat, King Faisal Medical Complex in Taif, Saudi Arabia Mohammed Jibreel Suliman Mohammed, Wirral University Teaching Hospital, United Kingdom Mona Awad Akasha Abuelgasim, Kingston Hospital NHS foundation trust, United Kingdom Monika Gureh, General surgery, AIIMS Bhuvneshwar, Bhuvneshwar, India Mouaqit Ouadii, Hassan II hospital, Morocco Mujdat Balkan, General Surgery, TOBB ETÜ Medical school, Ankara, Turkey Mumin Mohamed, Queen Elizabeth Hospital Birmingham, United Kingdom Musluh Hakseven, Ankara University School of Medicine Department of General Surgery, Surgical Oncology, Turkey Natalia Velenciuc, University of Medicine and Pharmacy Grigore T. Popa Iasi/ Regional Institute of Oncology Iasi, Romania Nicola Cillara, Chirurgia Generale PO Santissima Trinità Cagliari, Italy Nicola de'Angelis, Henri Mondor University Hospital (AP-HP), Faculty of Medicine, University of Paris Est, UPEC, France Nicolò Tamini, ASST MONZA - Ospedale San Gerardo, Italy Nikolaos J. Zavras, Department of Pediatric Surgery-General University Hospital "ATTIKON", Greece Nikolaos Machairas, General Hospital of Athens “Laiko”, Greece Nikolaos Michalopoulos, General University Hospital Attikon, Athens, Greece Nikolaos N. Koliakos, Univerisity Hospital Attikon, Athens, Greece Nikolaos Pararas, Dr Sulaiman Al Habib Hospital, Saudi Arabia Noel E. Donlon, Trinity college Dublin st James hospital, Ireland Noushif Medappil, Aster Malabar Institute of Medical Sciences (Aster MIMS - Calicut), India Offir Ben-Ishay, Surgical Oncology, Division of Surgery, Rambam Health Care Campus, Haifa, Israel Stefano Olmi, General and Oncological Surgery Department, Senior Research Vita-Salute, San Raffaele University, Milan, San Marco Hospital GSD, Zingonia (BG), Italy Omar Islam, Wirral university teaching hospital, United Kingdom Ömer Tammo, Mardin training and research hospital, Turkey Orestis Ioannidis, 4th Department of Surgery, Medical School, Aristotle University of Thessaloniki, General Hospital “George Papanikolaou”, Thessaloniki, Greece Oscar Aparicio, Parc Tauli Hospital Universitari Sabadell, Spain Oussama Baraket, Deprtement of surghery bizerte hospital, Faculty of medicine of Tunis, Tunisia Pankaj Kumar, Department of General Surgery, Bhubaneswar, Odisha, India Pasquale Cianci, Lorenzo Bonomo Hospital Andria-ASL BAT-University of Foggia, Italy Per Örtenwall, Department of surgery, Sahlgrenska University Hospital, Gothenburg, Sweden Petar Angelov Uchikov, Medical university of Plovdiv, Department of special surgery, Medical faculty, University hospital “St. George”, Plovdiv, Bulgaria Philip de Reuver, Department of Surgery, Radboudumc, Nijmegen, Netherlands Philip F. Stahel, Rocky Vista University College of Osteopathic Medicine, United States Philip S. Barie, Department of Surgery, Weill Cornell Medicine, New York, NY, United States Micaela Piccoli, Division of General Surgery, Emergency and New Technologies, Ospedale Civile Baggiovara, AOU, Modena, Italy Piotr Major, Jagiellonian University Medical College, Poland Pradeep H. Navsaria, Trauma Centre, Groote Schuur Hospital and University of Cape Town, South Africa Prakash Kumar Sasmal, All India Institute of Medical Sciences, Bhubaneswar, India Raul Coimbra, Riverside University Health System MEdical Center / Loma Linda University, United States Razrim Rahim, Universiti Sains Islam Malaysia, Malaysia Recayi Çapoğlu, General Surgery, Sakarya training and research hospital, Sakarya, Turkey Renol M. Koshy, Luton & Dunstable University Hospital, United Kingdom Ricardo Alessandro Teixeira Gonsaga, Centro Universitário Padre Albino, Catanduva (SP), Brazil Riccardo Pertile, Department of Clinical and Evaluative Epidemiology, Health Service of Trento, Italy Rifat Ramadan Mussa Mohamed, University Hospital Ayr, United Kingdom Rıza Deryol, Department of General Surgery, Surgical Oncology Unit, Ankara University, School of Medicine, Ankara, Turkey Robert G. Sawyer, Western Michigan University School of Medicine, United States Roberta Angelico, HPB and Transplant Unit, University of Rome Tor Vergata, Italy Roberta Ragozzino, General surgery and Trauma Team, ASST Niguarda, Milano, Piazza Ospedale Maggiore 3, Milan, Italy Roberto Bini, ASST Niguarda Hospital, Italy Roberto Cammarata, Campus Biomedico University of Rome, Italy Rosa Scaramuzzo, General Surgery Unit, San Paolo Hospital, Rome, Italy Rossella Gioco, General Surgery, Policlinico G. Rodolico Catania, Italy Ruslan Sydorchuk, General Surgery Department, Regional Emergency Hospital Chernivtsi, Ukraine Salma Ahmed, Wirral University Teaching Hospital, United Kingdom Salomone Di Saverio, Ospedale Madonna del Soccorso San benedetto del Tronto, Italy Sameh Hany Emile, Mansoura University Hospital, Egypt Samir Delibegovic, Department of Surgery, University Clinical Center Tuzla, Tuzla, Bosnia and Herzegovina Sanjay Marwah, Pt BDS Postgraduate Institute of Medical Sciences, Rohtak, Haryana, India Savvas Symeonidis, General Hospital of Thessaloniki Georgios Papanikolaou, Greece Scott G. Thomas, Trauma Services, Indiana University School of Medicine, Beacon Health System, Memorial Hospital South Bend, Indiana, United States Sebahattin Demir, Turkey Selmy S. Awad, Mansoura university hospitals, Mansoura University, Egypt Semra Demirli Atici, University of Health Sciences Tepecik Training and Research Hospital, Turkey Serge Chooklin, Lviv National Medical University, Ukraine Serhat Meric, General surgery department, Bağcılar training and research hospital, Istanbul, Turkey Sevcan Sarıkaya, Mardin Training and Research Hospital, Mardin, Turkey Sharfuddin Chowdhury, King Saud Medical City, Riyadh, Saudi Arabia Shaza Faycal Mirghani, Sandwell General Hospital, United Kingdom Sherry M. Wren, Stanford University, United States Simone Gargarella, University “G.D’Annunzio” Chieti – Pescara, Italy Simone Rossi Del Monte, ASL Roma 1 - Ospedale San Filippo Neri, Italy Sofia Esposito, General, emergency and new technology surgery Unit, Baggiovara General Hospital, Modena, Italy Sofia Xenaki, Department of General Surgery, University Hospital of Heraklion Crete, Greece Soliman Fayez Ghedan Mohamed, KFMC, Saudi Arabia Solomon Gurmu Beka, Emergency Surgery, Professional Specialist at Ethiopian Air Force Hospital, President of Ethiopian Emergency Surgery Association, Bishoftu, Oromia, Ethiopia Sorinel Lunca, University of Medecine "Gr.T.Popa" Iasi Second Oncology Surgery Clinic Regional Institute of Oncology Iasi, Romania Spiros G. Delis, University of Athens, Greece Spyridon Dritsas, Colorectal and Peritoneal Oncology Centre, The Christie NHS Foundation Trust, Manchester, United Kingdom Stefan Morarasu, 2nd Department of Surgical Oncology, Regional Institute of Oncology, Iasi, Romania Stefano Magnone, ASST Papa Giovanni XXIII Bergamo, Italy Stefano Rossi, Emergency surgery San Filippo Neri hospital ASL Roma1, Italy Stefanos Bitsianis, 4th Department of Surgery of Aristotle University of Thessaloniki, Greece Stylianos Kykalos, 2nd Department of Propaedeutic Surgery, General Hospital Laiko, National and Kapodistrian University of Athens, Greece Suman Baral, Dirghayu Pokhara Hospital, Pokhara, Nepal Sumita A Jain, SMS MEedical College and Hospital Jaipur, India Syed Muhammad Ali, Hamad Medical Corporation, Qatar Tadeja Pintar, Surgery Department, UMC Ljubljana, Ljubljana, Sloviena Tania Triantafyllou, Advanced Upper GI Surgical Fellow, Athens, Greece Tarik Delko, University Center for Gastrointestinal and Liver Diseases, Basel, Switzerland Teresa Perra, Università degli Studi di Sassari, Italy Theodoros A. Sidiropoulos, Surgical Resident, 4th Surgical Department, Attikon University Hospital, Athens, Greece Thomas M. Scalea, R Adams Cowley Shock Trauma Center, University of Maryland School of Medicine, United States Tim Oliver Vilz, Department of Surgery, University Hospital Bonn, Venusberg Campus 1, Bonn, Germany Timothy Craig Hardcastle, IALCH, Durban and University of KwaZulu-Natal, South Africa Tongporn Wannatoop, Department of Surgery, Faculty of Medicine Siriraj hospital, Mahidol university, Bankok, Thailand Torsten Herzog, Department of Surgery, St. Josef Hospital, Ruhr University Bochum, Germany Tushar Subhadarshan Mishra, Department of Surgery, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India Ugo Boggi, Division of General and Transplant Surgery, University of Pisa, Italy Valentin Calu, Elias Emergency University Hospital, Romania Valentina Tomajer, Ospedale San Raffaele Milan, Italy Vanni Agnoletti, Azienda USL della Romagna – Cesena, Italy Varut Lohsiriwat, Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand Victor Kong, Department of Surgery, University of KwaZulu Natal, Durban, South Africa Virginia Durán Muñoz-Cruzado, Virgen del Rocío University Hospital, Spain Vishal G. Shelat, Department of General Surgery, Tan Tock Seng Hospital, Singapore Vladimir Khokha, Department of surgery, Mozyr city hospital, Belarus Wagih Mommtaz Ghannam, Mansoura Faculty of Medicine, Egypt Walter L. Biffl, Scripps Clinic Medical Group, United States Wietse Zuidema, Amsterdam University Medical Center, Amsterdam, Netherlands Yasin Kara, Health Sciences University Kanuni Sultan Süleyman Training and Research Hospital General Surgery Clinic, Turkey Yoshiro Kobe, Chiba Emergency Medical Center, Japan Zaza Demetrashvili, Surgery Department, Tbilisi State Medical University, Georgia Ziad A. Memish, Research and Innovation Center, King Saud Medical City, Ministry of Health & College of Medicine Alfaisal University, Saudi Arabia Zoilo Madrazo, Bellvitge University Hospital, Barcelona, Spain Zsolt J. Balogh, Department of Traumatology, John Hunter Hospital and University of Newcastle, Australia Zulfu Bayhan, Sakarya University, Faculty of Medicine Department of General Surgery, Turkey Martin Reichert, Massimo Sartelli, Markus A. Weigand, Matthias Hecker, Ingolf H. Askevold, Juliane Liese, Winfried Padberg and Andreas Hecker: core investigator. Federico Coccolini and Fausto Catena: WSES project steering committee representative. Publisher Copyright: © 2022, The Author(s).
PY - 2022/12
Y1 - 2022/12
N2 - Background: The SARS-CoV-2 pandemic is still ongoing and a major challenge for health care services worldwide. In the first WSES COVID-19 emergency surgery survey, a strong negative impact on emergency surgery (ES) had been described already early in the pandemic situation. However, the knowledge is limited about current effects of the pandemic on patient flow through emergency rooms, daily routine and decision making in ES as well as their changes over time during the last two pandemic years. This second WSES COVID-19 emergency surgery survey investigates the impact of the SARS-CoV-2 pandemic on ES during the course of the pandemic. Methods: A web survey had been distributed to medical specialists in ES during a four-week period from January 2022, investigating the impact of the pandemic on patients and septic diseases both requiring ES, structural problems due to the pandemic and time-to-intervention in ES routine. Results: 367 collaborators from 59 countries responded to the survey. The majority indicated that the pandemic still significantly impacts on treatment and outcome of surgical emergency patients (83.1% and 78.5%, respectively). As reasons, the collaborators reported decreased case load in ES (44.7%), but patients presenting with more prolonged and severe diseases, especially concerning perforated appendicitis (62.1%) and diverticulitis (57.5%). Otherwise, approximately 50% of the participants still observe a delay in time-to-intervention in ES compared with the situation before the pandemic. Relevant causes leading to enlarged time-to-intervention in ES during the pandemic are persistent problems with in-hospital logistics, lacks in medical staff as well as operating room and intensive care capacities during the pandemic. This leads not only to the need for triage or transferring of ES patients to other hospitals, reported by 64.0% and 48.8% of the collaborators, respectively, but also to paradigm shifts in treatment modalities to non-operative approaches reported by 67.3% of the participants, especially in uncomplicated appendicitis, cholecystitis and multiple-recurrent diverticulitis. Conclusions: The SARS-CoV-2 pandemic still significantly impacts on care and outcome of patients in ES. Well-known problems with in-hospital logistics are not sufficiently resolved by now; however, medical staff shortages and reduced capacities have been dramatically aggravated over last two pandemic years.
AB - Background: The SARS-CoV-2 pandemic is still ongoing and a major challenge for health care services worldwide. In the first WSES COVID-19 emergency surgery survey, a strong negative impact on emergency surgery (ES) had been described already early in the pandemic situation. However, the knowledge is limited about current effects of the pandemic on patient flow through emergency rooms, daily routine and decision making in ES as well as their changes over time during the last two pandemic years. This second WSES COVID-19 emergency surgery survey investigates the impact of the SARS-CoV-2 pandemic on ES during the course of the pandemic. Methods: A web survey had been distributed to medical specialists in ES during a four-week period from January 2022, investigating the impact of the pandemic on patients and septic diseases both requiring ES, structural problems due to the pandemic and time-to-intervention in ES routine. Results: 367 collaborators from 59 countries responded to the survey. The majority indicated that the pandemic still significantly impacts on treatment and outcome of surgical emergency patients (83.1% and 78.5%, respectively). As reasons, the collaborators reported decreased case load in ES (44.7%), but patients presenting with more prolonged and severe diseases, especially concerning perforated appendicitis (62.1%) and diverticulitis (57.5%). Otherwise, approximately 50% of the participants still observe a delay in time-to-intervention in ES compared with the situation before the pandemic. Relevant causes leading to enlarged time-to-intervention in ES during the pandemic are persistent problems with in-hospital logistics, lacks in medical staff as well as operating room and intensive care capacities during the pandemic. This leads not only to the need for triage or transferring of ES patients to other hospitals, reported by 64.0% and 48.8% of the collaborators, respectively, but also to paradigm shifts in treatment modalities to non-operative approaches reported by 67.3% of the participants, especially in uncomplicated appendicitis, cholecystitis and multiple-recurrent diverticulitis. Conclusions: The SARS-CoV-2 pandemic still significantly impacts on care and outcome of patients in ES. Well-known problems with in-hospital logistics are not sufficiently resolved by now; however, medical staff shortages and reduced capacities have been dramatically aggravated over last two pandemic years.
KW - Appendicitis
KW - COVID-19
KW - Capacity
KW - Emergency
KW - Emergency surgery
KW - Pandemic
KW - Quarantine
KW - SARS-CoV-2
KW - Time to intervention
KW - WSES
UR - http://www.scopus.com/inward/record.url?scp=85132144052&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85132144052&partnerID=8YFLogxK
U2 - 10.1186/s13017-022-00424-0
DO - 10.1186/s13017-022-00424-0
M3 - Article
C2 - 35710386
AN - SCOPUS:85132144052
SN - 1749-7922
VL - 17
JO - World Journal of Emergency Surgery
JF - World Journal of Emergency Surgery
IS - 1
M1 - 34
ER -