Simple and Effective Primary Assessment of Emergency Patients in a COVID-19 Outbreak Area: A Retrospective, Observational Study

Figures & data

Table 1 Preoperative Characteristics of Study Patients with Emergency Surgery, According to Identification of Suspicious for COVID-19

Characteristic	All Patients (N=88)	Non-Suspected (n=52)	Suspected (n=36)	P value*
Age, mean (SD), y	37.1 (17.8)	32.7 (13.0)	43.6 (21.7)	<0.001
Sex
Female	63/88 (71.6%)	45/52 (86.5%)	18/36 (50.0%)	<0.001
Male	25/88 (28.4%)	7/52 (13.5%)	18/36 (50.0%)
Comorbidities
Hypertension	3/88 (3.4%)	1/52 (1.9%)	2/36 (5.6%)	0.565
Diabetes	3/88 (3.4%)	0/52	3/36 (8.3%)	0.06507
Temperature>37.2°C	16/88 (18.2%)	0/52	16/36 (44.4%)	<0.001
Abnormal on chest CT	25/35 (71.4%)	0/8	25/27 (92.6%)	<0.001
Laboratory findings**
White blood cell count, ×10^9 per L
4–10	54/85 (63.5%)	37/49 (75.5%)	17/36 (47.2%)	0.01901
<4	4/85 (4.7%)	1/49 (2.0%)	3/36 (8.3%)
>10	27/85 (31.8%)	11/49 (22.4%)	16/36 (44.4%)
Lymphocyte count, ×10^9 per L
1.1–3.2	59/85 (69.4%)	40/49 (81.6%)	19/36 (52.8%)	0.01208
<1.1	22/85 (25.9%)	8/49 (16.3%)	14/36 (38.9%)
>3.2	4/85 (4.7%)	1/49 (2.0%)	3/36 (8.3%)
Lymphocytes percentage
20%–40%	26/85 (30.6%)	21/49 (42.9%)	5/36 (13.9%)	0.00865
<20%	59/85 (69.4%)	28/49 (57.1%)	31/36 (86.1%)
CRP>3.14 mg/L or hs-CRP>10 mg/dL	25/68 (36.8%)	9/43 (20.9%)	16/25 (64.0%)	<0.001

Notes: *P values indicate differences between Non-suspected and Suspected patients. P < 0.05 was considered statistically significant.** Children” value are classified according to pediatric normal ranges.

Table 2 Surgery Characteristics of Study Patients with Emergency Surgery

Characteristic	All Patients (N=88)	Non-Suspected (n=52)	Suspected (n=36)	P value
Reoperation for inpatients	9/88 (10.2%)	2/52 (3.8%)	7/36 (19.4%)	0.02873
Median waiting times for surgery (IQR), d	1.00 (3.00)	1.00 (2.00)	1.50 (7.25)	0.05294
ASA scores
I	3/88 (3.4%)	1/52 (1.9%)	2/36 (5.6%)	0.00374
II	54/88 (61.4%)	40/52 (76.9%)	14/36 (38.9%)
III	20/88 (22.7%)	8/52 (15.4%)	12/36 (33.3%)
IV	11/88 (12.5%)	3/52 (5.8%)	8/36 (22.2%)
Median prepare time (IQR), min	44.0 (20.0)	41.5 (18.0)	46.0 (37.0)	0.1039
Anesthesia technique
General anesthesia	39/88 (44.3%)	10/52 (19.2%)	29/36 (80.6%)	<0.001
Non-general anesthesia	49/88 (55.7%)	42/52 (80.8%)	7/36 (19.4%)
Emergence in OR	31/88 (35.2%)	9/52 (17.3%)	22/36 (61.1%)	<0.001
Median time until SOMCT recovery (IQR), min	23.0 (16.5)	23.0 (2.00)	22.0 (24.0)	0.5855
Cases transferred to ICU	8/88 (9.1%)	1/52 (1.9%)	7/36 (19.4%)	0.00722
Surgical specialty
Gastrointestinal	12/88 (13.6%)	3/52 (5.8%)	9/36 (25.0%)	<0.001
Cardiac	6/88 (6.8%)	0/52	6/36 (16.7%)
Obstetrics	46/88 (52.3%)	39/52 (75.0%)	7/36 (19.4%)
Thoracic	2/88 (2.3%)	0/52	2/36 (5.6%)
Otorhinolaryngology	3/88 (3.4%)	1/52 (1.9%)	2/36 (5.6%)
Ophthalmology	4/88 (4.5%)	1/52 (1.9%)	3/36 (8.3%)
Traumatic	14/88 (15.9%)	8/52 (15.4%)	6/36 (16.7%)
Pediatric	1/88 (1.1%)	0/52	1/36 (2.8%)

Table 3 Postoperative Characteristics of Study Patients with Emergency Surgery

Characteristic	All Patients (N=88)	Non-Suspected (n=52)	Suspected (n=36)	P value
Within 7 days postoperatively
Highest temperature >37.2°C	18/88 (20.5%)	5/52 (9.6%)	13/36 (36.1%)	0.00576
Mean white blood cell count, ×10^9/L
4–10	33/81 (40.7%)	16/47 (34.0%)	17/34 (50.0%)	0.225
>10	48/81 (59.3%)	31/47 (66.0%)	17/34 (50.0%)
Mean lymphocyte count, ×10^9/L
1.1–3.2	54/81 (66.7%)	39/47 (83.0%)	15/34 (44.1%)	<0.001
<1.1	26/81 (32.1%)	7/47 (14.9%)	19/34 (55.9%)
>3.2	1/81 (1.2%)	1/47 (2.1%)	0/34
Mean lymphocytes percentage
20%–40%	14/81 (17.3%)	8/47 (17.0%)	6/34 (17.6%)	0.693
<20%	66/81 (81.5%)	38/47 (80.9%)	28/34 (82.4%)
>40%	1/81 (1.2%)	1/47 (2.1%)	0/34
CRP or hs-CRP available	77/88 (87.5%)	47/52 (90.4%)	30/36 (83.3%)	0.3461
Mean CRP (SD), mg/L	82.2 (59.5)	57.3 (45.7)	92.2 (62.7)	0.233
Mean hs-CRP (SD), mg/dL	78.0 (49.2)	78.0 (49.5)	78.0 (50.0)	0.9983
Confirmed COVID-19 Cases	6/88 (6.8%)	0/52	6/36 (16.7%)	0.00359
Median postoperative length of stay (IQR), d	5.00 (4.00)	5.00 (2.00)	7.00 (5.50)	0.03535