Effect of COVID-19 Pandemic on Presentation and Outcomes of Gallstone Disease
DOI:
https://doi.org/10.51273/esc22.251843Keywords:
Covid-19, gallstone disease, complicated gallstone, surgical emergencyAbstract
Objective: To determine the effect of Covid-19 pandemic on presentation and outcomes of gallstone disease and to compare them with the pre-covid time.
Methods: it is a retrospective observationalstudy conducted in surgical emergency department of holy family hospital, Rawalpindi. Data of all the patients presented to emergency department (ED) fromApril toAugust 2020 (Group I) and in the same months of 2019 (Group II) was collected retrospectively. More patients presented with complicated gallstone disease in emergency department during COVID'19 than in pre-covid time. Covid'19is anindependentriskfactorforpresentationofpatientsinemergencydepartmentwith complications.
Results: There were 108 (53%) patients in Group I and 95 (47%) patients in Group II retained in emergency department (ED) of General surgery, holy family hospital, Rawalpindi. There were more patients admitted through ED in Group I than in Group II (63[58%] vs 40[42%] p-value 0.003). In Group I patients, duration of symptoms was prolonged before reaching ED than Group II (3.55+1.45 vs 2.86+1.32 days, p-value 0.001). Moreover, patients presented with more severe disease assessed by Tokyo criteria and number of patients with complicated gallstone disease in Group I were also higher (p-value 0.01).
Conclusion: During covid-19 pandemic, patients were reluctant to attend hospitals for elective surgeries as a result of fear of the COVID'19. Moreover, due to cancellation of elective procedures during lockdown, there were more patients admitted through Emergency Department with severe and complicated gallstone disease. Hence COVID19 is an independent risk factor for presentation of patients in ED with complications.
How to cite: Dar SM, Bhutta MK, Zia H, Bashir MN, Khan JS, Qureshi U, Rasheed G. Effect of COVID-19 Pandemic
on Presentation and Outcomes of Gallstone Disease. Esculapio - JSIMS 2022;18(04):248-252
References
Farber ON,Gomez GI,Titan AL,Fisher AT,Puntasecca CJ, Arana VT, Kempinsky A, Wise CE, Bessoff KE, HawnMT, KorndorfferJrJR. Impact of COVID-19 on presentation,management,and out comes of acute care surgery for gall bladder disease and acute appendicitis. World Journal of Gastrointestinal Surgery. 2021 Aug 8;13(8):859.
WuZ,McGooganJM.Characteristics of and important lessons from the corona virus disease 2019 (COVID19) out breakin China: summary of are port of 72314 cases from the Chinese Center for Disease Control and Pre-vention. JAMA. 2020.
ASCA State Guidance of Elective Surgeries. [cited10 February 2021]. Available from:https://www.ascassociation.org/asca/resourcecenter/Latestnewsresourcece nter/covid-19/covid-19-state.
Coronavirus Disease 2019. Non-Emergent, Elective Medical Services, and Treatment Recommendations [cited 10 February 2021 ].Availablefrom:https://www. medicaid.gov/resources-for-states/disaster-response- toolkit /coronavirus-disease-2019-covid-19/index.html
Khan AA, Lodhi FS, Rabbani U, Ahmed Z, Abrar S, ArshadS,IrumSandKhanMI(2021)Impact of Corona virus Disease(COVID-19)PandemiconPsychological Well Being of the Pakistani General Population. Front. Psychiatry 11:564364.doi:10.3389/fpsyt.2020.564364
CzeislerMÉ,MarynakK,ClarkeKEN,SalahZ,Shakya I, Thierry JM, Ali N, McMillan H, Wiley JF, Weaver MD, Czeisler CA, Rajaratnam SMW, Howard ME. Delay or Avoidance of Medical Care Because of COVID-19-RelatedConcerns UnitedStates,June2020. MMWR Morb Mortal Wkly Rep. 2020 (PMC free article) (PubMed)
Schirmer BD, Winters KL, Edlich RF. Cholelithiasis and cholecystitis. J Long Term Eff Med Implants. 2005;15(3):329-338.doi:10.1615/jlongtermeffmedim plants. v15.i3.90
Shabanzadeh DM. Incidence of gallstone disease and complications. Curr Opin Gastroenterol. 2018; 34(2): 81-89. doi:10.1097/MOG.0000000000000418
YokoeM,HataJ,TakadaT,etal.TokyoGuidelines2018: diagnostic criteria and severity grading of acute chole-cystitis (with videos). J Hepatobiliary Pancreat Sci. 2018;25(1):41-54. doi:10.1002/jhbp.515.
LeVH,SmithDE,JohnsonBL.Conversionoflaparo-scopicto open cholecystectomy in the current era of laparoscopic surgery. Am Surg. 2012;78(12):1392-5. PMID: 23265130.
CremerA,ArvanitakisM.Diagnosisandmanagement of bile stone disease and its complications. Minerva Gastroenterol Dietol. 2016;62(1):103-29. PMID: 26 771377.
Hartnett KP, Kite-Powell A, DeVies J, et al. Impact of the COVID-19 Pandemic on Emergency Department Visits - United States, January 1, 2019-May 30, 2020. MMWR Morb Mortal Wkly Rep. 2020;69(23):699-704.Published2020Jun12.doi:10.15585/mmwr.mm6923e1
LauraE.Wong,JessicaE.HawkinsandSimoneLangness et al. Where Are All the Patients? Addressing Covid-19FeartoEncourageSickPatientstoSeekEmergency Care. Nejm Catalyst Innovations in Care Delivery. 2020. DOI: 10.1056/CAT.20.0193.
Sandblom G, Österberg J, Rogmark P, et al. Impact of the COVID-19 pandemic on the management of gall-stone surgery: ASwedish population-based study. ScandJSurg.2022;111(1):14574969211070389.doi:10.1177/14574969211070389.
Koch F, Hohenstein S, Bollmann A, Meier-Hellmann A,KuhlenR,RitzJP.CholecystectomiesintheCOVID-19 Pandemic During and After the First Lockdown in Germany:anAnalysisof8561Patients.JGastrointest Surg. 2022;26(2):408-413. doi:10.1007/s11605-021-05157-0.
ManziaTM,AngelicoR,ParenteA,MuiesanP,Tisone G; MEGAVID (ManagEment of GAllstone disease during coVID-19 pandemic) Clinical Investigator Group. Global management of a common, underrated surgicaltaskduringtheCOVID-19pandemic:Gallstone disease-Aninternationalsurvery.AnnMedSurg(Lond). 2020;57:95-102.Published2020Jul17.doi:10.1016/j.amsu.2020.07.021.
