Impact of the COVID-19 Pandemic on the Treatment of Abdominal Emergency Diseases in Japan

Postoperative Short-term Outcomes of Perforation of the Digestive Tract

Abstract

The COVID-19 pandemic had various impacts in the field of health care. In the case of emergency treatment, problems related to the patient acceptance system became pronounced, including an increase in difficulty of emergency transport. Delayed therapeutic intervention was also reported to have exerted an impact on the therapeutic outcomes. In this study, we examined the impact of the COVID-19 pandemic on the postoperative short-term outcomes of patients with gastroduodenal perforation and colorectal perforation, using the National Clinical Database. In the months in which the risk-adjusted standardized mortality (morbidity) ratio (SMR) was significantly high, gastroduodenal perforation occurred once as a postoperative complication, and colorectal perforation occurred twice in 30-day mortality data and once as a postoperative complication. Since there was no period with a significantly elevated SMR for surgical mortality from either disease, the negative impact of the pandemic on these diseases was limited; thus, it appears that the emergency medical system for abdominal emergency diseases was largely maintained in Japan. Under emergency situations, such as during a novel infectious disease epidemic, it becomes necessary to provide efficient and effective medical treatment with limited medical resources. Therefore, it is important to establish appropriate triage functions based on the severity of individual diseases and urgency of the need for therapeutic intervention, to ensure that medical facilities are available for patient acceptance, and to promote cooperation and division of roles among medical facilities.