Table 4.
Overview of postoperative surgical outcomes during first COVID-19 wave, second COVID-19 wave, and interim period in 2020 compared with those of historical reference cohorts that underwent surgery between 1 January 2018 and 31 December 2020
| First wave (n = 1919) | Reference first wave (n = 5430) | P§ | Second wave (n = 3310) | Reference second wave (n = 7537) | P§ | Interim period (n = 4021) | Reference interim period (n = 8940) | P§ | |
|---|---|---|---|---|---|---|---|---|---|
| Duration of hospital stay (days), median (i.q.r.) | 5 (3–8) | 4 (2–8) | <0.001 | 4 (2–8) | 4 (2–8) | 0.060 | 4 (2–7) | 4 (2–8) | 0.003 |
| Oncological | 5 (3–9) | 6 (4–9) | 0.046 | 5 (3–9) | 6 (3–10) | 0.011 | 5 (3–9) | 6 (4–10) | 0.001 |
| Non-oncological | 4 (2–7) | 3 (1–7) | <0.001 | 3 (1–7) | 2 (1–6) | 0.008 | 3 (1–6) | 2 (1–6) | 0.588 |
| Severe complication * | 187 (9.7) | 458 (8.4) | <0.001 | 300 (9.1) | 589 (7.8) | 0.002 | 337 (8.4) | 795 (8.9) | 0.778 |
| Oncological | 177 (15.8) | 393 (16.6) | 0.574 | 258 (15.9) | 505 (15.2) | 0.558 | 285 (16.4) | 704 (17.1) | 0.512 |
| Non-oncological | 10 (1.3) | 65 (2.1) | 0.707 | 42 (2.5) | 84 (2.0) | 0.006 | 52(2.3) | 91 (1.9) | 0.178 |
| Not registered† | 601 (31.1) | 1525 (28,1) | 1047 (31.6) | 2035 (27.0) | 1216 (30.2) | 2437 (27.3) | |||
| Missing | 3 (0.2) | 8 (0.1) | 1 (0.0) | 13 (0.2) | 2 (0.0) | 17 (0.2) | |||
| Readmission within 30 days | 135 (7.0) | 340 (6.3) | 0.222 | 199 (6.0) | 431 (5.7) | 0.693 | 266 (6.6) | 535 (6.0) | 0.198 |
| Oncological | 110 (9.8) | 240 (10.1) | 0.335 | 155 (9.6) | 295 (8.9) | 1.000 | 193 (11.1) | 394 (9.6) | 0.401 |
| Non-oncological | 25 (3.1) | 100 (3.3) | 0.260 | 44 (2.6) | 136 (3.2) | 0.524 | 73 (3.2) | 141 (2.9) | 0.366 |
| Not registered† | 380 (19.8) | 1063 (19.6) | 566 (17.1) | 1440 (19.1) | 715 (17.8) | 1692 (18.9) | |||
| Missing | 18 (0.9) | 29 (0.5) | 60 (1.8) | 69 (0.9) | 20 (0.5) | 43 (0.5) | |||
| Postoperative death | 57 (3.0) | 164 (3.0) | 0.342 | 136 (4.1) | 227 (3.0) | 0.011 | 103 (2.6) | 227 (2.5) | 0.928 |
| Oncological | 19 (1.9) | 63 (2.7) | 0.308 | 68 (4.4) | 88 (2.6) | 0.004 | 39 (2.2) | 76 (1.8) | 0.539 |
| Non-oncological | 36 (4.5) | 101 (3.3) | 0.089 | 60 (3.8) | 139 (3.3) | 0.460 | 63 (2.8) | 151 (3.1) | 0.551 |
| Perioperative COVID-19 infection‡ | 2 (0.1) | – | 8 (0.2) | – | 1 (0.0) | – | |||
| ICU admission | 354 (18.4) | 918 (16.9) | 0.030 | 530 (16.0) | 1246 (16.5) | <0.001 | 618 (15.4) | 1516 (17.0) | <0.001 |
| Oncological | 223 (19.9) | 524 (22.1) | 0.062 | 291 (18.0) | 697 (21.0) | <0.001 | 332 (19.1) | 989 (21.8) | <0.001 |
| Non-oncological | 131 (16.4) | 394 (12.9) | <0.001 | 239 (14.1) | 549 (13.0) | <0.001 | 286 (12.5) | 618 (12.8) | <0.001 |
| Not registered† | 380 (19.8) | 840 (15.5) | 566 (17.1) | 1115 (14.8) | 715 (17.8) | 1310 (14.7) | |||
| Missing | 54 (2.8) | 190 (3.5) | 39 (1.2) | 268 (3.6) | 58 (1.4) | 398 (4.5) | |||
| Duration of ICU stay (days), median (i.q.r.) | 0 (0–1) | 0 (0–1) | 0.076 | 0 (0–1) | 0 (0–1) | 0.001 | 0 (0–1) | 0 (0–1) | 0.064 |
| Oncological data | n = 821 | n = 1750 | n = 1204 | n = 2413 | n = 1253 | n = 3068 | |||
| Resection margins | 0.291 | 0.001 | 0.164 | ||||||
| R0 | 695 (84.7) | 1495 (85.4) | 1011 (84.0) | 2097 (86.9) | 1053 (84.0) | 2618 (85.3) | |||
| R1 | 53 (6.5) | 85 (4.9) | 77 (6.4) | 104 (4.3) | 72 (5.7) | 139 (4.5) | |||
| R2 | 3 (0.4) | 2 (0.1) | 4 (0.3) | 7 (0.3) | 5 (0.4) | 6 (0.2) | |||
| Unknown | 39 (3.5) | 80 (3.4) | 52 (4.3) | 124 (5.1) | 50 (3.9) | 135 (4.4) | |||
| Not registered† | 33 (2.9) | 78 (3.3) | 63 (5.2) | 70 (2.9) | 68 (5.4) | 136 (4.4) | |||
| Missing | 79 (7.0) | 176 (7.4) | 112 (11.1) | 237 (11.3) | 137 (10.9) | 270 (8.8) | |||
| Disease stage | 0.191 | <0.001 | <0.001 | ||||||
| 0 | 42 (5.1) | 60 (3.4) | 38 (3.2) | 80 (3.3) | 32 (2.6) | 101 (3.3) | |||
| I | 220 (26.8) | 501 (28.6) | 309 (25.7) | 708 (29.3) | 312 (24.9) | 919 (30.0) | |||
| II | 234 (28.5) | 438 (25.0) | 324 (26.9) | 657 (27.2) | 356 (28.4) | 831 (27.1) | |||
| III | 212 (25.8) | 509 (29.1) | 349 (29.0) | 698 (28.9) | 348 (27.8) | 842 (27.4) | |||
| IV | 35 (4.3) | 84 (4.8) | 42 (3.5) | 121 (5.0) | 68 (5.4) | 119 (3.9) | |||
| X | 20 (2.4) | 38 (2.2) | 42 (3.5) | 28 (1.2) | 36 (2.9) | 60 (2.0) | |||
| Not registered† | 234 (20.9) | 439 (18.5) | 300 (24.8) | 646 (26.7) | 361 (28.8) | 752 (28.7) | |||
| Missing | 58 (7.1) | 120 (6.9) | 100 (8.3) | 121 (5.0) | 101 (8.1) | 196 (6.4) |
Values are n (%) unless otherwise indicated.
Needing reintervention, ICU admission and/or causing death. †Variable not registered in certain surgery-specific audits. An overview of registered variables that are available in only a selection of audits is provided in Table S1. Non-registered data were excluded from analyses. An overview of postoperative surgical outcomes for each audit is available in Table S4.
‡ Patients with a confirmed perioperative COVID-19 infection who died after surgery from any cause (including non-COVID related causes). §Pearson’s χ2 test, except ¶Mann–Whitney U test.