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    A Nation-wide Review of Elective Surgery and COVID-Surge Capacity

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    Author
    Prasad, Nikhil K
    Englum, Brian R
    Turner, Douglas J
    Lake, Rachel
    Siddiqui, Tariq
    Mayorga-Carlin, Minerva
    Sorkin, John D
    Lal, Brajesh K
    Date
    2021-06-19
    Journal
    Journal of Surgical Research
    Publisher
    Elsevier Inc.
    Type
    Article
    
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    See at
    https://doi.org/10.1016/j.jss.2021.05.028
    http://www.ncbi.nlm.nih.gov/pmc/articles/pmc8213966/
    Abstract
    Background: The COVID-19 pandemic has resulted in over 225,000 excess deaths in the United States. A moratorium on elective surgery was placed early in the pandemic to reduce risk to patients and staff and preserve critical care resources. This report evaluates the impact of the elective surgical moratorium on case volumes and intensive care unit (ICU) bed utilization. Methods: This retrospective review used a national convenience sample to correlate trends in the weekly rates of surgical cases at 170 Veterans Affairs Hospitals around the United States from January 1 to September 30, 2020 to national trends in the COVID-19 pandemic. We reviewed data on weekly number of procedures performed and ICU bed usage, stratified by level of urgency (elective, urgent, emergency), and whether an ICU bed was required within 24 hours of surgery. National data on the proportion of COVID-19 positive test results and mortality rates were obtained from the Center for Disease Control website. Results: 198,911 unique surgical procedures performed during the study period. The total number of cases performed from January 1 to March 16 was 86,004 compared with 15,699 from March 17 to May 17. The reduction in volume occurred before an increase in the percentage of COVID-19 positive test results and deaths nationally. There was a 91% reduction from baseline in the number of elective surgeries performed allowing 78% of surgical ICU beds to be available for COVID-19 positive patients. Conclusion: The moratorium on elective surgical cases was timely and effective in creating bed capacity for critically ill COVID-19 patients. Further analyses will allow targeted resource allocation for future pandemic planning.
    Rights/Terms
    Copyright © 2021 Elsevier Inc. All rights reserved.
    Keyword
    critical care resources conservation
    elective surgery moratorium
    Surgery, Elective
    COVID-19
    Health Resources
    Hospitals, Veterans
    Identifier to cite or link to this item
    http://hdl.handle.net/10713/16088
    ae974a485f413a2113503eed53cd6c53
    10.1016/j.jss.2021.05.028
    Scopus Count
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    UMB Coronavirus Publications
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