EP.FRI.763 Impact of COVID-19 on the rates of emergency laparotomies at an acute general hospital in the United Kingdom

Published Date: 28th October 2021

Publication Authors: Wright C, Kirkham S, Millward A, Macadam R

Aims
The aim of this study was to analyse if the COVID-19 pandemic had any effect on the number of emergency laparotomies performed each month at a single NHS Foundation Trust.

Method
This single-centre retrospective observational study included all patients that underwent an emergency laparotomy that was registered as part of the National Emergency Laparotomy Audit (NELA) at Whiston Hospital in Merseyside, UK, between January 2019 and October 2020. The rates recorded throughout March and April 2020 (COVID) were then compared to the preceding 12 months until the first COVID death was recorded in the UK on March 5th, and the 6 months following the initial national lockdown.

Results
The number of emergency laparotomies performed each month declined from an average of 14.7 (95% CI 13.2 – 16.1) in the preceding 12 months to 5 during COVID (95% CI 5 – 5); a decrease of 65.9%. Following the easing of lockdown rules in early May, this decline was partly reversed with an average of 9.7 (95% CI 8.9 – 10.5) performed each month until October 2020, reflecting a 34.1% reduction from the pre-COVID baseline. The percentage of patients that achieved the NELA best practice tariffs also fell during COVID to 71% from an average of 79.3% (95% CI 76.0 – 82.7) due to fewer high risk laparotomies being admitted to Critical Care post-operatively.

Conclusion
During the COVID-19 pandemic, emergency laparotomy rates fell and have only partially recovered to pre-pandemic rates. Post-operative admission to critical care for high risk laparotomies also declined during this period.

Wright, C; Kirkham, S; Millward, A; MacAdam, R. (2021). EP.FRI.763 Impact of COVID-19 on the rates of emergency laparotomies at an acute general hospital in the United Kingdom. British Journal of Surgery. 108 (Suppl 7)

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