• Oscar Cano-Valderrama, Xavier Morales, Carlos J Ferrigni, Esteban Martín-Antona, Victor Turrado, Alejandro García, Yolanda Cuñarro-López, Leire Zarain-Obrador, Manuel Duran-Poveda, José M Balibrea, and Antonio J Torres.
• Department of Surgery, Hospital Clínico San Carlos, Madrid, Spain; Department of Surgery, Universidad Complutense, Madrid, Spain; Instituto de Investigación Sanitaria San Carlos, Madrid, Spain. Electronic address: oscarcanovalderrama@hotmail.com.
• Int J Surg. 2020 Aug 1; 80: 157-161.

Backgroundduring the COVID-19 pandemic, the number of Acute Care Surgery procedures performed in Spanish hospitals decreased significantly. The aim of this study was to compare Acute Care Surgery activity during the COVID-19 pandemic and during a control period.Material And Methodsa multicenter retrospective cohort study was performed including patients who underwent Acute Care Surgery in three tertiary care hospitals in Spain during a control (11th March 2019 to 21st April 2019) and a pandemic (16th March 2020 to 26th April 2020) period. Type of surgical procedures, patients' features and postoperative complications were compared.Resultstwo hundred and eighty-five and 117 patients were included in each group. Mean number of patients who underwent Acute Care Surgery during the control and pandemic periods was 2.3 and 0.9 patients per day and hospital (p < 0.001), representing a 58.9% decrease in Acute Care Surgery activity. Time from symptoms onset to patient arrival at the Emergency Department was longer during the pandemic (44.6 vs. 71.0 h, p < 0.001). Surgeries due to acute cholecystitis and complications from previous elective procedures decreased (26.7% vs. 9.4%) during the pandemic, while bowel obstructions and abdominal wall hernia surgeries increased (12.3% vs. 22.2%) (p = 0.001). Morbidity was higher during pandemic period (34.7% vs. 47.1%, p = 0.022), although this difference was not statistically significant in the multivariate analysis. Reoperation rate (17.9% vs. 12.8%, p = 0.212) and mortality (6.7% vs. 4.3%, p = 0.358) were similar in both groups.Conclusionduring the COVID-19 pandemic, a significant reduction in the performance of Acute Care Surgery procedures was observed. Moreso, a longer time from symptoms onset to patient arrival at the Emergency Department was noted. Higher morbidity was observed in patients undergoing Acute Care Surgery during the pandemic period, although there was not any difference in mortality or reoperation rate.Copyright © 2020 IJS Publishing Group Ltd. Published by Elsevier Ltd. All rights reserved.

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