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Publications

Journal Article Multicenter Study Ppublish

PubMed: 38896918 DOI: 10.1016/j.healthpol.2024.105113

Surgical reorganization during the COVID-19 pandemic and impact on case-mix and surgical site infections: A multicenter cohort study in Italy.

Health Policy 146:105113

Authors: Costanza Vicentini, Elettra Ugliono, Heba Safwat Mhmoued Abdo Elhadidy, Giovanni Paladini, Alessandro Roberto Cornio, Federico Cussotto, Mario Morino, Carla Maria Zotti

Affiliations

  • Department of Public Health and Paediatrics, University of Turin, Via Santena 5 bis, 10126, Turin, Italy.
  • Department of Surgical Sciences, University of Turin, Corso A.M. Dogliotti 14, 10126 Turin, Italy.
  • Department of Public Health and Paediatrics, University of Turin, Via Santena 5 bis, 10126, Turin, Italy.

Abstract

BACKGROUND

The coronavirus 2019 (COVID-19) pandemic led to major disruptions in surgical activity, particularly in the first year (2020). The objective of this study was to assess the impact of surgical reorganization on surgical outcomes in Northern Italy in 2020 and 2021.

METHODS

A retrospective cohort study was conducted among 30 hospitals participating in the surveillance system for surgical site infections (SSIs). Abdominal surgery procedures performed between 2018 and 2021 were considered. Predicted SSI rates for 2020 and 2021 were estimated based on 2018-2019 data and compared with observed rates. Independent predictors for SSI were investigated using logistic regression, including procedure year.

RESULTS

7605 procedures were included. Significant differences in case-mix were found comparing the three time periods. Observed SSI rates among all patients in 2020 were significantly lower than expected based on 2018-2019 SSI rates (p 0.0465). Patients undergoing procedures other than cancer surgery in 2020 had significantly lower odds for SSI (odds ratio, OR 0.52, 95 % confidence interval, CI 0.3-0.89, p 0.018) and patients undergoing surgery in 2021 had significantly higher odds for SSI (OR 1.49, 95 % CI 1.07-2.09, p 0.019) compared to 2018-2019.

CONCLUSIONS

Enhanced infection prevention and control (IPC) measures could explain the reduced SSI risk during the first pandemic year. IPC practices should continue to be reinforced beyond the pandemic context.

MeSH

Education, Medical, Surgical Wound Infection, Cohort Studies, Covid-19, Infection Control, Health Planning, Pandemics, Health Education, General Surgery, Infections