The Impact of the Covid-19 Outbreak on Emergency Room Attendances of Surgical Patients

Study Overview
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Brief Summary
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Since December 2019, when the novel coronavirus disease (Covid-19) spread throughout the world, data have been needed on the effects of the pandemic on various aspects of healthcare systems. Recommendations for social distancing and quarantine decrees made by local governments, alongside the general public fear from the spread of the virus, are presumed to have markedly affected the trends in hospitals visits. Understanding the exact nature of the effect is critical for better anticipating and preparing health systems in the event of future outbreaks and in the post outbreak period. Therefore we intend to To identify retrospectively all patients who presented to the emergency department at our medical institute between January 1 - March 31 in the following years: 2017, 2018, 2019, 2020. We will examine the impact of COVID-19 on the rates of surgical emergency visits, ratio of surgical visits to non-surgical visits, the ratio of severe presentations to non-severe presentations, and the impact of age on ED attendance.

Detailed Description
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Since December 2019, when the novel coronavirus disease (Covid-19) spread throughout the world, data have been needed on the effects of the pandemic on various aspects of healthcare systems. Recommendations for social distancing and quarantine decrees made by local governments, alongside the general public fear from the spread of the virus, are presumed to have markedly affected the trends in hospitals visits. Understanding the exact nature of the effect is critical for better anticipating and preparing health systems in the event of future outbreaks and in the post outbreak period. Additionally, deferring hospitals visits can potentially put patients at increased risk for morbidity and mortality, especially in postsurgical patients. Evaluating the impact of the pandemic on patient volume can guide decision-making in future scenarios. Previous infectious disease outbreaks have been shown to impact ED volumes: The US Hantavirus outbreak in 1993 led to a 2-fold increase in ED visits; Escherichia coli 0157:H7 outbreak in Washington state in 1993 increased ED visits by 17%; However, the 2003 SARS outbreaks in Hong Kong, Taiwan, and Toronto reduced tertiary care ED visits by up to 47 percent.

Official Title
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The Impact of the Coronavirus Disease 2019 (Covid-19) Outbreak on Emergency Room Attendances of Surgical Patients at a Tertiary Medical Center

Conditions
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Emergency Service, Hospital, General Surgery

Intervention / Treatment
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* Other: COVID-19 Pandemic


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: All patients visiting the ER of Sheba Medical Center between January 1 - March 31 in the following years: 2017, 2018, 2019, 2020 Exclusion Criteria: Patients less than 18 years of age

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Pandemic Period<br>Patients who presented to the emergency department at our medical institute Sheba Medical Center between January 1 - March 31 in 2020. | Other: COVID-19 Pandemic<br>* Exposure: the novel coronavirus disease (Covid-19) outbreak<br>|
| Pre Pandemic Period<br>Patients who presented to the emergency department at our medical institute Sheba Medical Center between January 1 - March 31 in the following years: 2017, 2018, 2019, | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Rates of emergency visits needing surgical consult |  | January 1 - March 31 in the following years: 2017, 2018, 2019, 2020 | 
| The ratio of severe presentations to non-severe presentations |  | January 1 - March 31 in the following years: 2017, 2018, 2019, 2020 | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| The impact of age on ED attendance rates |  | January 1 - March 31 in the following years: 2017, 2018, 2019, 2020 | 
| Differences in ED surgical visits (in terms of capacity and severity) of surgical patients depending on the presentation and the co morbidity |  | January 1 - March 31 in the following years: 2017, 2018, 2019, 2020 | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Emergency, Surgery, Covid-19