Effects of an increase in emergency cases with difficulties in transport to hospital during the COVID‐19 pandemic on postoperative short‐term outcomes of colorectal perforation: A study based on the National Clinical Database
Abstract Aim During the COVID‐19 pandemic, there were delays in transport of emergency cases to hospital by ambulance due to increased difficulties in obtaining hospital acceptance. The aim of this study was to examine if this had a negative effect on postoperative short‐term outcomes in patients wi...
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| Format: | Article |
| Language: | English |
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Wiley
2025-05-01
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| Series: | Annals of Gastroenterological Surgery |
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| Online Access: | https://doi.org/10.1002/ags3.12887 |
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| author | Shimpei Ogawa Hideki Endo Masahiro Yoshida Tomomitsu Tsuru Michio Itabashi Hiroyuki Yamamoto Yoshihiro Kakeji Hideki Ueno Ken Shirabe Taizo Hibi Akinobu Taketomi Norihiko Ikeda Masaki Mori |
| author_facet | Shimpei Ogawa Hideki Endo Masahiro Yoshida Tomomitsu Tsuru Michio Itabashi Hiroyuki Yamamoto Yoshihiro Kakeji Hideki Ueno Ken Shirabe Taizo Hibi Akinobu Taketomi Norihiko Ikeda Masaki Mori |
| author_sort | Shimpei Ogawa |
| collection | DOAJ |
| description | Abstract Aim During the COVID‐19 pandemic, there were delays in transport of emergency cases to hospital by ambulance due to increased difficulties in obtaining hospital acceptance. The aim of this study was to examine if this had a negative effect on postoperative short‐term outcomes in patients with colorectal perforation. Methods The National Clinical Database (NCD) includes >95% of surgical cases in Japan. Postoperative 30‐day mortality, surgical mortality, and postoperative complications (Clavien–Dindo grade ≥3) were examined in 17 770 cases of colorectal perforation registered from 2019 to 2022 in the NCD. These outcomes were compared for cases with new COVID‐19 infection and emergency cases with difficulties in transport to hospital. Months were considered to have significantly high or low mortality or complication rates, if the 95% confidence interval (CI) of the standardized mortality (morbidity) ratio (SMR) did not contain 1. Results Postoperative 30‐day mortality occurred in 1826 cases (10.3%), surgical mortality in 2382 cases (13.4%), and postoperative complications in 5276 cases (29.7%). Significantly higher SMRs were found for 30‐day mortality in November 2020 (1.44 [95% CI: 1.07–1.89]) and February 2021 (1.54 [95% CI: 1.14–2.03]), and for postoperative complications in June 2020 (1.27 [95% CI: 1.07–1.50]). In 2022, there were marked increases in new COVID‐19 cases and in emergency cases with difficulties in transport to hospital, but no month had a significantly high SMR. Conclusions Emergency cases with difficulties in transport markedly increased during the COVID‐19 pandemic but had little effect on short‐term outcomes of colorectal perforation. |
| format | Article |
| id | doaj-art-af5fbf47711e41f5bbcb4be710eacd8f |
| institution | OA Journals |
| issn | 2475-0328 |
| language | English |
| publishDate | 2025-05-01 |
| publisher | Wiley |
| record_format | Article |
| series | Annals of Gastroenterological Surgery |
| spelling | doaj-art-af5fbf47711e41f5bbcb4be710eacd8f2025-08-20T01:51:58ZengWileyAnnals of Gastroenterological Surgery2475-03282025-05-019350551710.1002/ags3.12887Effects of an increase in emergency cases with difficulties in transport to hospital during the COVID‐19 pandemic on postoperative short‐term outcomes of colorectal perforation: A study based on the National Clinical DatabaseShimpei Ogawa0Hideki Endo1Masahiro Yoshida2Tomomitsu Tsuru3Michio Itabashi4Hiroyuki Yamamoto5Yoshihiro Kakeji6Hideki Ueno7Ken Shirabe8Taizo Hibi9Akinobu Taketomi10Norihiko Ikeda11Masaki Mori12The Japanese Society for Abdominal Emergency Medicine Tokyo JapanDepartment of Healthcare Quality Assessment, Graduate School of Medicine The University of Tokyo Tokyo JapanThe Japanese Society for Abdominal Emergency Medicine Tokyo JapanThe Japanese Society for Abdominal Emergency Medicine Tokyo JapanThe Japanese Society for Abdominal Emergency Medicine Tokyo JapanDepartment of Healthcare Quality Assessment, Graduate School of Medicine The University of Tokyo Tokyo JapanDatabase Committee The Japanese Society of Gastroenterological Surgery Tokyo JapanDatabase Committee The Japanese Society of Gastroenterological Surgery Tokyo JapanThe Japanese Society of Gastroenterological Surgery Tokyo JapanThe Japan Surgical Society Tokyo JapanThe Japan Surgical Society Tokyo JapanThe Japan Surgical Society Tokyo JapanThe Japan Surgical Society Tokyo JapanAbstract Aim During the COVID‐19 pandemic, there were delays in transport of emergency cases to hospital by ambulance due to increased difficulties in obtaining hospital acceptance. The aim of this study was to examine if this had a negative effect on postoperative short‐term outcomes in patients with colorectal perforation. Methods The National Clinical Database (NCD) includes >95% of surgical cases in Japan. Postoperative 30‐day mortality, surgical mortality, and postoperative complications (Clavien–Dindo grade ≥3) were examined in 17 770 cases of colorectal perforation registered from 2019 to 2022 in the NCD. These outcomes were compared for cases with new COVID‐19 infection and emergency cases with difficulties in transport to hospital. Months were considered to have significantly high or low mortality or complication rates, if the 95% confidence interval (CI) of the standardized mortality (morbidity) ratio (SMR) did not contain 1. Results Postoperative 30‐day mortality occurred in 1826 cases (10.3%), surgical mortality in 2382 cases (13.4%), and postoperative complications in 5276 cases (29.7%). Significantly higher SMRs were found for 30‐day mortality in November 2020 (1.44 [95% CI: 1.07–1.89]) and February 2021 (1.54 [95% CI: 1.14–2.03]), and for postoperative complications in June 2020 (1.27 [95% CI: 1.07–1.50]). In 2022, there were marked increases in new COVID‐19 cases and in emergency cases with difficulties in transport to hospital, but no month had a significantly high SMR. Conclusions Emergency cases with difficulties in transport markedly increased during the COVID‐19 pandemic but had little effect on short‐term outcomes of colorectal perforation.https://doi.org/10.1002/ags3.12887colorectal perforationCOVID‐19emergency cases with difficulties in transport to hospitalNational Clinical Databasepostoperative short‐term outcomes |
| spellingShingle | Shimpei Ogawa Hideki Endo Masahiro Yoshida Tomomitsu Tsuru Michio Itabashi Hiroyuki Yamamoto Yoshihiro Kakeji Hideki Ueno Ken Shirabe Taizo Hibi Akinobu Taketomi Norihiko Ikeda Masaki Mori Effects of an increase in emergency cases with difficulties in transport to hospital during the COVID‐19 pandemic on postoperative short‐term outcomes of colorectal perforation: A study based on the National Clinical Database Annals of Gastroenterological Surgery colorectal perforation COVID‐19 emergency cases with difficulties in transport to hospital National Clinical Database postoperative short‐term outcomes |
| title | Effects of an increase in emergency cases with difficulties in transport to hospital during the COVID‐19 pandemic on postoperative short‐term outcomes of colorectal perforation: A study based on the National Clinical Database |
| title_full | Effects of an increase in emergency cases with difficulties in transport to hospital during the COVID‐19 pandemic on postoperative short‐term outcomes of colorectal perforation: A study based on the National Clinical Database |
| title_fullStr | Effects of an increase in emergency cases with difficulties in transport to hospital during the COVID‐19 pandemic on postoperative short‐term outcomes of colorectal perforation: A study based on the National Clinical Database |
| title_full_unstemmed | Effects of an increase in emergency cases with difficulties in transport to hospital during the COVID‐19 pandemic on postoperative short‐term outcomes of colorectal perforation: A study based on the National Clinical Database |
| title_short | Effects of an increase in emergency cases with difficulties in transport to hospital during the COVID‐19 pandemic on postoperative short‐term outcomes of colorectal perforation: A study based on the National Clinical Database |
| title_sort | effects of an increase in emergency cases with difficulties in transport to hospital during the covid 19 pandemic on postoperative short term outcomes of colorectal perforation a study based on the national clinical database |
| topic | colorectal perforation COVID‐19 emergency cases with difficulties in transport to hospital National Clinical Database postoperative short‐term outcomes |
| url | https://doi.org/10.1002/ags3.12887 |
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