Influence of the COVID-19 Pandemic on Dutch Surgical Patterns of Care

Study Overview
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Brief Summary
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The aim of this study is to determine the impact of the COVID-19 pandemic on the Dutch surgical care, expressed as number of performed procedures, altered treatment plans, and surgical outcomes in the Netherlands during the year 2020.

Detailed Description
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The aim of this study is to determine the impact of the COVID-19 pandemic on the Dutch surgical care, expressed as number of performed procedures, altered treatment plans, and surgical outcomes in the Netherlands during the year 2020. This was done by executing a nationwide prospective cohort study, under the name Dutch COVIDsurg II Snapshot Study. This study was conducted in collaboration with the Dutch Institute of Clinical Auditing (DICA). For this study, the surgical audits for lung cancer surgery (DLCA-S), Upper gastrointestinal cancer surgery (DUCA), pancreatic cancer surgery (DPCA), hepatobiliary surgery (DHBA), colorectal cancer surgery (DCRA), hip fracture surgery (DHFA), aortic aneurysm surgery (DSAA), and bariatric surgery (DATO), were expanded with an additional COVID-19 survey, since August 2020. This survey focused on alterations in, or delay of treatment and diagnostics, perioperative outcomes, and specific COVID-19 related symptoms and complications during the COVID-19 pandemic. All academic-, general community-, teaching- and non-teaching hospitals in the Netherlands performing pulmonary, upper gastrointestinal, pancreatic, hepatobiliary, colorectal, hip fracture, aneurysmal or bariatric procedures were approached to participate in the Dutch COVIDSurg II Snapshot study. Patients who underwent surgery during the period January 1st 2018 until December 31st 2019, were included in the historical cohort. Patients who underwent a surgical procedure in the period January 1st 2020 until December 31st 2020 were included in the study group.

Official Title
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The Influence of the COVID-19 Pandemic on Surgical Patterns of Care in the Netherlands: a Prospective Nationwide Study

Conditions
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COVID-19

Intervention / Treatment
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* Other: no intervention


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: All patients who underwent pulmonary, upper gastrointestinal, pancreatic, hepatobiliary, colorectal, hip fracture, aneurysm or bariatric surgery Alle patients >18 years Patients undergoing surgery during the period January 1st 2018 until December 31st 2020 Hospital that performs the surgery has to participate in the study Exclusion Criteria: none

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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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Cohort 2018<br>All surgically treated patients in the surgical audits for lung cancer surgery (DLCA-S), Upper gastrointestinal cancer surgery (DUCA), pancreatic cancer surgery (DPCA), hepatobiliary surgery (DHBA), colorectal cancer surgery (DCRA), hip fracture surgery (DHFA), aortic aneurysm surgery (DSAA), and bariatric surgery (DATO), from the participating hospitals in 2018 | Other: no intervention<br>* no intervention was applied<br>|
| Cohort 2019<br>All surgically treated patients in the surgical audits for lung cancer surgery (DLCA-S), Upper gastrointestinal cancer surgery (DUCA), pancreatic cancer surgery (DPCA), hepatobiliary surgery (DHBA), colorectal cancer surgery (DCRA), hip fracture surgery (DHFA), aortic aneurysm surgery (DSAA), and bariatric surgery (DATO), from the participating hospitals in 2019 | Other: no intervention<br>* no intervention was applied<br>|
| Cohort 2020<br>All surgically treated patients in the surgical audits for lung cancer surgery (DLCA-S), Upper gastrointestinal cancer surgery (DUCA), pancreatic cancer surgery (DPCA), hepatobiliary surgery (DHBA), colorectal cancer surgery (DCRA), hip fracture surgery (DHFA), aortic aneurysm surgery (DSAA), and bariatric surgery (DATO), from the participating hospitals in 2020 | Other: no intervention<br>* no intervention was applied<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Number of performed surgical procedures | The data on surgical outcomes was collected through the database of the Dutch Institute for Clinical Auditing | 2018-2020 | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Length of hospital stay (days) | Data was collected through an additional COVID-19 survey and through the database of the Dutch Institute for Clinical Auditing | 2018-2020 | 
| 30-day hospital readmissions (percentage) | Data was collected through an additional COVID-19 survey and through the database of the Dutch Institute for Clinical Auditing | 2018-2020 | 
| severe complications (Clavien-Dindo grade > 3A) | Severe complications are defined as Clavien-Dindo grading system Data was collected through an additional COVID-19 survey and through the database of the Dutch Institute for Clinical Auditing | 2018-2020 | 
| ICU admission (percentage) | Data was collected through an additional COVID-19 survey and through the database of the Dutch Institute for Clinical Auditing | 2018-2020 | 
| length of ICU stay (days) | Data was collected through an additional COVID-19 survey and through the database of the Dutch Institute for Clinical Auditing | 2018-2020 | 
| mortality rate (percentage) | Data was collected through an additional COVID-19 survey and through the database of the Dutch Institute for Clinical Auditing Mortality is defined as mortality during hospital stay or within 30 days after surgery | 2018-2020 | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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surgery, COVID-19