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Open Access

Emergency general surgery utilization and disparities during COVID-19: an interrupted time-series analysis

Anya L Greenberg, Hope Schwartz, Caitlin R Collins, Yvonne M Kelly, Robert Mackersie, Michelle Mourad, John P Roberts, Tasce Bongiovanni
DOI: 10.1136/tsaco-2021-000679 Published 18 March 2021
Anya L Greenberg
1School of Medicine, University of California San Francisco, San Francisco, California, USA
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  • ORCID record for Anya L Greenberg
Hope Schwartz
1School of Medicine, University of California San Francisco, San Francisco, California, USA
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Caitlin R Collins
2Department of Surgery, University of California San Francisco, San Francisco, California, USA
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Yvonne M Kelly
2Department of Surgery, University of California San Francisco, San Francisco, California, USA
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Robert Mackersie
2Department of Surgery, University of California San Francisco, San Francisco, California, USA
3Department of Trauma and Acute Care Surgery, Zuckerberg San Francisco General Hospital and Trauma Center, San Francisco, California, USA
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Michelle Mourad
4Department of Medicine, University of California San Francisco, San Francisco, California, USA
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John P Roberts
2Department of Surgery, University of California San Francisco, San Francisco, California, USA
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Tasce Bongiovanni
2Department of Surgery, University of California San Francisco, San Francisco, California, USA
3Department of Trauma and Acute Care Surgery, Zuckerberg San Francisco General Hospital and Trauma Center, San Francisco, California, USA
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  • Figure 1
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    Figure 1

    General surgery emergency presentation volumes before and during the COVID-19 pandemic. ED, emergency department.

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    Figure 2

    Peritonitis (A) and gallbladder disease (B) emergency department (ED) presentation volumes before and during the COVID-19 pandemic.

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    Figure 3

    Percentage of patients with surgical intervention for general surgery emergency before and during the COVID-19 pandemic. ED, emergency department.

Tables

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  • Table 1

    Demographic characteristics pre-COVID-19 and during COVID-19

    Pre-COVID-19 (n=3255)Post-COVID-19 (n=546)P value
    Mean/N%Mean/N%
    Age56.8653.950.001
    Age group (years)0.001
     18–344731511421
     35–496642011721
     50–649002812723
     65+12183718834
    Gender0.058
     Female16034929354
     Male16505125346
    Race/Ethnicity0.181
     White or Caucasian15264726949
     Asian6492010519
     Hispanic or Latino532167514
     Black or African-American2638468
     American Indian, Alaska Native,
     Native Hawaiian or other Pacific Islander
    79271
     Other/Unknown2066448
    Interpreter needed<0.001
     Yes485156712
     No27358547087
     Unknown2051
    Coverage type0.024
     Medicare13314119636
     Private coverage12103823844
     Medi-Cal6692110219
     Other451102
  • Table 2

    Disease severity metrics pre-COVID-19 and during COVID-19

    Pre-COVID-19 (n=3255)Post-COVID-19 (n=546)P value
    Mean/N%Mean/N%
    Surgery0.007
     No15694929754
     Yes16865224946
    SOI<0.001
     Minor349147319
     Moderate6422512632
     Major8203211630
     Extreme769307720
    LOS5.503.91<0.001
    WBC at presentation11.2410.800.225
    Maximum WBC in the first 24 hours11.8311.370.230
    Sepsis6502083150.009
    • LOS, length of stay; SOI, severity of illness; WBC, white blood cell.

Supplementary Materials

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  • Supplementary data

    [tsaco-2021-000679supp001.pdf]

Additional Files

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  • Supplementary Data

    This web only file has been produced by the BMJ Publishing Group from an electronic file supplied by the author(s) and has not been edited for content.

    • Data supplement 1
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Emergency general surgery utilization and disparities during COVID-19: an interrupted time-series analysis
Anya L Greenberg, Hope Schwartz, Caitlin R Collins, Yvonne M Kelly, Robert Mackersie, Michelle Mourad, John P Roberts, Tasce Bongiovanni
Trauma Surg Acute Care Open Mar 2021, 6 (1) e000679; DOI: 10.1136/tsaco-2021-000679

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Emergency general surgery utilization and disparities during COVID-19: an interrupted time-series analysis
Anya L Greenberg, Hope Schwartz, Caitlin R Collins, Yvonne M Kelly, Robert Mackersie, Michelle Mourad, John P Roberts, Tasce Bongiovanni
Trauma Surg Acute Care Open Mar 2021, 6 (1) e000679; DOI: 10.1136/tsaco-2021-000679
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Emergency general surgery utilization and disparities during COVID-19: an interrupted time-series analysis
Anya L Greenberg, Hope Schwartz, Caitlin R Collins, Yvonne M Kelly, Robert Mackersie, Michelle Mourad, John P Roberts, Tasce Bongiovanni
Trauma Surgery & Acute Care Open Mar 2021, 6 (1) e000679; DOI: 10.1136/tsaco-2021-000679
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