I-ACTSS-COVID-19-the Italian acute care and trauma surgery survey for COVID-19 pandemic outbreak

Valerio Cozza, Pietro Fransvea, Antonio La Greca, Paolo De Paolis, Pierluigi Marini, Mauro Zago, Gabriele Sganga, I.-ACTSS.-COVID19 Collaborative Study Group, Valerio Cozza, Pietro Fransvea, Antonio La Greca, Paolo De Paolis, Pierluigi Marini, Mauro Zago, Gabriele Sganga, I.-ACTSS.-COVID19 Collaborative Study Group

Abstract

The sudden COVID-19 outbreak in Italy has challenged our health systems and doctors faced the challenge of treating a large number of critically ill patients in a short time interval. Acute care surgeons, although not directly involved in treating COVID-19 + patients, have often modified their daily activity to help in this crisis. We have designed the first Italian survey on the effect of COVID-19 outbreak on Acute Care Surgery activity and submitted it to emergency surgeons in all the country to evaluate the experiences, trends, attitudes and possible educational outcomes that this emergency brought to light. A total of 532 valid surveys were collected during the study period. Lombardy and Lazio had the major answer rate. 96% of responders noticed a decrease in surgical emergencies. The outbreak affected regions and hospitals in different ways depending on the local incidence of infection. Half of responders modified their approach to intra-abdominal infections towards a more conservative treatment. 43% of responders, mainly in the North, were shifted to assist non-surgical patients. There has been a direct but non-homogeneous involvement of emergency surgeons. Almost all hospitals have responded with specific pathways and training. Both emergency surgery and trauma activity have changed and generally decreased but the majority of surgeons have operated on suspected COVID-19 patients.

Keywords: Acute care surgery; COVID-19; Emergency; Healthcare workers; Outbreak; Pandemic.

Conflict of interest statement

The authors declare no potential conflict/competing of interest related to this manuscript.

Figures

Fig. 1
Fig. 1
Geographical origin of respondent surgeons
Fig. 2
Fig. 2
Hospital type and capacity
Fig. 3
Fig. 3
Numbers of surgical procedures performed on suspected COVID-19 or on positive patients
Fig. 4
Fig. 4
Approach to the most common diseases
Fig. 5
Fig. 5
Impact of COVID-19 outbreak on healthcare workers

References

    1. Livingston E, Bucher K. Coronavirus Disease 2019 (COVID-19) in Italy. JAMA. 2020 doi: 10.1001/jama.2020.4344.
    1. Tong A. Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups. Int J Qual Health Care. 2007;19(6):349–357. doi: 10.1093/intqhc/mzm042.
    1. Sohrabi C, Alsafi Z, O'Neill N, et al. World Health Organization declares global emergency: a review of the 2019 novel coronavirus (COVID-19) Int J Surg. 2020;76:71–76. doi: 10.1016/j.ijsu.2020.02.034.
    1. Coccolini F, Sartelli M, Kluger Y, et al. COVID-19 the showdown for mass casualty preparedness and management: the Cassandra Syndrome. World J Emerg Surg. 2020;15(1):26. doi: 10.1186/s13017-020-00304-5.
    1. COVIDSurg Collaborative Global guidance for surgical care during the COVID-19 pandemic. Br J Surg. 2020 doi: 10.1002/bjs.11646.
    1. Coimbra R, Edwards S, Kurihara H, et al. European society of trauma and emergency surgery (ESTES) recommendations for trauma and emergency surgery preparation during times of COVID-19 infection. Eur J Trauma Emerg Surg. 2020;46(3):505–510. doi: 10.1007/s00068-020-01364-7.
    1. Alhazzani W, Møller MH, Arabi YM, et al. Surviving sepsis campaign: guidelines on the management of critically ill adults with Coronavirus Disease 2019 (COVID-19) Intensive Care Med. 2020;46(5):854–887. doi: 10.1007/s00134-020-06022-5.
    1. Angelos G, Dockter AG, Gachabayov M, Latifi R, Bergamaschi R. Emergency colorectal surgery in a COVID-19 pandemic epicenter. Surg Technol Int. 2020;36:18–21.

Source: PubMed

赞助者和合作者

医疗条件

药物干预

3
订阅