TY - JOUR
T1 - Impact of the COVID-19 pandemic on surgical care in the Netherlands
AU - de Graaff, Michelle R.
AU - Hogenbirk, Rianne N. M.
AU - Janssen, Yester F.
AU - Elfrink, Arthur K. E.
AU - Liem, Ronald S. L.
AU - Nienhuijs, Simon W.
AU - de Vries, Jean-Paul P. M.
AU - Elshof, Jan-Willem
AU - Verdaasdonk, Emiel
AU - Melenhorst, Jarno
AU - van Westreenen, H. L.
AU - Besselink, Marc G. H.
AU - Ruurda, Jelle P.
AU - Henegouwen, Mark I. van Berge
AU - Klaase, Joost M.
AU - den Dulk, Marcel
AU - van Heijl, Mark
AU - Hegeman, Johannes H.
AU - Braun, Jerry
AU - Voeten, Daan M.
AU - Wurdemann, Franka S.
AU - Warps, Anne-Loes K.
AU - Alberga, Anna J.
AU - Suurmeijer, J. Annelie
AU - Akpinar, Erman O.
AU - Wolfhagen, Nienke
AU - van den Boom, Anne Loes
AU - Bolster-van Eenennaam, Marieke J.
AU - van Duijvendijk, Peter
AU - Heineman, David J.
AU - Wouters, Michel W. J. M.
AU - Kruijff, Schelto
N1 - Publisher Copyright:
© 2022 The Author(s). Published by Oxford University Press on behalf of BJS Society Ltd.
PY - 2022/12/1
Y1 - 2022/12/1
N2 - Background: The COVID-19 pandemic caused disruption of regular healthcare leading to reduced hospital attendances, repurposing of surgical facilities, and cancellation of cancer screening programmes. This study aimed to determine the impact of COVID-19 on surgical care in the Netherlands. Methods: A nationwide study was conducted in collaboration with the Dutch Institute for Clinical Auditing. Eight surgical audits were expanded with items regarding alterations in scheduling and treatment plans. Data on procedures performed in 2020 were compared with those from a historical cohort (2018-2019). Endpoints included total numbers of procedures performed and altered treatment plans. Secondary endpoints included complication, readmission, and mortality rates. Results: Some 12 154 procedures were performed in participating hospitals in 2020, representing a decrease of 13.6 per cent compared with 2018-2019. The largest reduction (29.2 per cent) was for non-cancer procedures during the first COVID-19 wave. Surgical treatment was postponed for 9.6 per cent of patients. Alterations in surgical treatment plans were observed in 1.7 per cent. Time from diagnosis to surgery decreased (to 28 days in 2020, from 34 days in 2019 and 36 days in 2018; P < 0.001). For cancer-related procedures, duration of hospital stay decreased (5 versus 6 days; P < 0.001). Audit-specific complications, readmission, and mortality rates were unchanged, but ICU admissions decreased (16.5 versus 16.8 per cent; P < 0.001). Conclusion: The reduction in the number of surgical operations was greatest for those without cancer. Where surgery was undertaken, it appeared to be delivered safely, with similar complication and mortality rates, fewer admissions to ICU, and a shorter hospital stay.
AB - Background: The COVID-19 pandemic caused disruption of regular healthcare leading to reduced hospital attendances, repurposing of surgical facilities, and cancellation of cancer screening programmes. This study aimed to determine the impact of COVID-19 on surgical care in the Netherlands. Methods: A nationwide study was conducted in collaboration with the Dutch Institute for Clinical Auditing. Eight surgical audits were expanded with items regarding alterations in scheduling and treatment plans. Data on procedures performed in 2020 were compared with those from a historical cohort (2018-2019). Endpoints included total numbers of procedures performed and altered treatment plans. Secondary endpoints included complication, readmission, and mortality rates. Results: Some 12 154 procedures were performed in participating hospitals in 2020, representing a decrease of 13.6 per cent compared with 2018-2019. The largest reduction (29.2 per cent) was for non-cancer procedures during the first COVID-19 wave. Surgical treatment was postponed for 9.6 per cent of patients. Alterations in surgical treatment plans were observed in 1.7 per cent. Time from diagnosis to surgery decreased (to 28 days in 2020, from 34 days in 2019 and 36 days in 2018; P < 0.001). For cancer-related procedures, duration of hospital stay decreased (5 versus 6 days; P < 0.001). Audit-specific complications, readmission, and mortality rates were unchanged, but ICU admissions decreased (16.5 versus 16.8 per cent; P < 0.001). Conclusion: The reduction in the number of surgical operations was greatest for those without cancer. Where surgery was undertaken, it appeared to be delivered safely, with similar complication and mortality rates, fewer admissions to ICU, and a shorter hospital stay.
UR - http://www.scopus.com/inward/record.url?scp=85148772516&partnerID=8YFLogxK
U2 - 10.1093/bjs/znac301
DO - 10.1093/bjs/znac301
M3 - Article
SN - 0007-1323
VL - 109
SP - 1282
EP - 1292
JO - British Journal of Surgery
JF - British Journal of Surgery
IS - 12
ER -