Dynamics of indicators of multidisciplinary hospitals in Saint-Petersburg when providing emergency surgical care to patients with acute abdominal surgical diseases in the conditions of the covid-19 pandemic
Saint-Petersburg I.I. Dzhanelidze research institute of emergency medicine, Saint Petersburg, Budapeshtskaya str., 3
S.M. Kirov Military Medical Academy, Saint Petersburg, Akademika Lebedeva str., 6
The article presents the main changes in the indicators of emergency surgical care in Saint Petersburg after the beginning of the spread of COVID-19 in acute diseases of the abdominal cavity in adults, united by the general concept of «sharp stomach»: acute appendicitis, acute cholecystitis, acute pancreatitis, perforated gastric and duodenal ulcers, acute gastroduodenal bleeding, strangulated hernias and acute intestinal obstruction. Information for 6 months of 2019 and 6 months 2020 was analyzed.
The total number and ratio of individual forms of «sharp stomach», as well as surgical interventions performed during emergency surgical care, changed slightly. The most significant decrease in the number of patients (by 12,45 %) in 2020 was observed in patients with acute gastroduodenal bleeding (among operated patients - by 14,97 %), and with acute cholecystitis - by 8,57 % (among operated patients - by 4,59 %) compared to 2019. The number of operated patients with acute intestinal obstruction decreased by 13,07 %. At the same time, the number of operated patients with acute pancreatitis increased by 22,99 %.
There was no significant change in overall operational activity: 74,04 % in 2020 and 72,53% in 2019, respectively. The largest (by 8,37 %) decrease in the indicator was recorded at the acute intestinal obstruction (from 85,62 % to 77,25 %). The leading positions in the number of operated patients are traditionally occupied by acute appendicitis, pinched hernia, acute intestinal obstruction, perforated gastric ulcer and duodenal ulcer.
There was no significant dynamics of postoperative mortality. For 6 months in 2020 (compared to the same period in 2019), it decreased in acute intestinal obstruction (from 8,53 % to 6,13 %), perforated gastric ulcer and duodenal ulcer (from 14,63 % to 13,41 %), slightly increased in pinched hernia (from 3,75 % to 4,51 %), acute cholecystitis (from 1,56 % to 2,02 %), acute pancreatitis (from 15,71 % to 17,13 %). Traditionally, low mortality was observed in acute appendicitis (0.14 % and 0.09 %, respectively).
The analysis presented the preservation of the total volume of acute surgical pathology in the city, which indicates, on the one hand, the reliability of the data obtained, which remains the same both in peacetime and during the pandemic, on the other - the ability of the surgical service to cope with its tasks and in a complex epidemic situation.
emergency surgical care, abdominal surgery, «sharp stomach», surgery activity, mortality, COVID-19.
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