Abstract Background This study assessed the impact of the first COVID-19 wave in England on outcomes for acute appendicitis, gallstone disease, intestinal obstruction, diverticular disease, and abdominal wall hernia. Methods Emergency surgical admissions for patients aged 18 years and older to 124 NHS Trust hospitals between January and June in 2019 and 2020 were extracted from Hospital Episode Statistics. The risk of 90-day mortality after admission during weeks 11–19 in 2020 (national lockdown) and 2019 (pre-COVID-19) was estimated using multilevel logistic regression with case-mix adjustment. The primary outcome was all-cause mortality at 90 days. Results There were 12 231 emergency admissions and 564 deaths within 90 days during weeks 11–19 in 2020, compared with 18 428 admissions and 542 deaths in the same interval in 2019. Overall, 90-day mortality was higher in 2020 versus 2019, with an adjusted OR of 1.95 (95 per cent c.i. 0.78 to 4.89) for appendicitis, 2.66 (1.81 to 3.92) for gallstone disease, 1.99 (1.44 to 2.74) for diverticular disease, 1.70 (1.13 to 2.55) for hernia, and 1.22 (1.01 to 1.47) for intestinal obstruction. After emergency surgery, 90-day mortality was higher in 2020 versus 2019 for gallstone disease (OR 3.37, 1.26 to 9.02), diverticular disease (OR 2.35, 1.16 to 4.73), and hernia (OR 2.34, 1.23 to 4.45). For intestinal obstruction, the corresponding OR was 0.91 (0.59 to 1.41). For admissions not leading to emergency surgery, mortality was higher in 2020 versus 2019 for gallstone disease (OR 2.55, 1.67 to 3.88), diverticular disease (1.90, 1.32 to 2.73), and intestinal obstruction (OR 1.30, 1.06 to 1.60). Conclusion Emergency admission was reduced during the first lockdown in England and this was associated with higher 90-day mortality.

中文翻译：

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第一波 COVID-19 对常见急性外科疾病急诊入院后结果的影响：英格兰国家数据库分析

摘要 背景本研究评估了英格兰第一波 COVID-19 对急性阑尾炎、胆结石疾病、肠梗阻、憩室病和腹壁疝的影响。 方法2019 年和 2020 年 1 月至 6 月期间，124 家 NHS Trust 医院的 18 岁及以上患者的紧急手术入院情况是从医院事件统计数据中提取的。使用多级逻辑回归和病例组合调整来估计 2020 年（国家封锁）和 2019 年（COVID-19 之前）入院后第 11 至 19 周的 90 天死亡率风险。主要结局是 90 天的全因死亡率。 结果2020 年第 11 至 19 周，90 天内有 12 231 例急诊入院和 564 例死亡，而 2019 年同期有 18 428 例入院和 542 例死亡。总体而言，2020 年 90 天内死亡率高于 2019 年，阑尾炎的调整后 OR 为 1.95（95% CI 0.78 至 4.89），胆石病为 2.66（1.81 至 3.92），憩室病为 1.99（1.44 至 2.74），疝气为 1.70（1.13 至 2.55），疝气为 1.22（1.01 至 3.92）。 1.47）肠梗阻。急诊手术后，2020 年胆石病（OR 3.37，1.26 至 9.02）、憩室病（OR 2.35，1.16 至 4.73）和疝气（OR 2.34，1.23 至 4.45）的 90 天死亡率较高。对于肠梗阻，相应的 OR 为 0.91（0.59 至 1.41）。对于未进行急诊手术的入院患者，2020 年胆石病（OR 2.55、1.67 至 3.88）、憩室病（1.90、1.32 至 2.73）和肠梗阻（OR 1.30、1.06 至 1.60）的死亡率较高。 结论在英格兰第一次封锁期间，紧急入院人数减少，这与 90 天死亡率较高有关。