Impact of Measures Taken to Contain COVID-19 on Hospital Surgical Care Services and Clinical Outcomes

Swift and decisive actions on the part of healthcare and hospital authorities are required to effectively contain the current COVID-19 pandemic. These measures firstly allow personnel and facilities leeway to provide surge capabilities to meet anticipated increased demands on the healthcare service. In addition, by deferring none urgent hospital visits, admissions and investigations, such measures support social distancing and aid attempts to control disease transmission. Deferring perceived non-urgent patient services may however lead to unintended delayed diagnoses and exacerbation of current patient conditions and lead to increased emergency admissions and surgeries.

A policy decision was made that essential surgical services pertaining to cancer and urgent cardiovascular surgery were allowed but that surgeons had the option to postpone what is assessed to be less urgent cases. Increasingly patients also postpone their surgeries or visits because of anxieties over the developing situation. Elective surgical services at the Outram Campus were thus significantly reduced from January 2020 as part of the measures to contain the COVID-19 outbreak.

The surgical philosophy during this period was that a judicious policy that allowed surgeons to proceed with surgery deemed critical but to postpone those deemed less so will at the system level, avoid poor outcomes for patients who required surgery and yet successfully re-allocate resources required to address the unfolding pandemic.

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Key information

Conditions

COVID-19 Coronaviridae Infections Coronavirus Infections Infections Lung Diseases Nidovirales Infections Pneumonia Pneumonia, Viral RNA Virus Infections Respiratory Tract Diseases Respiratory Tract Infections Virus Diseases

Age range

21 year–100 year

Sex eligibility

All sexes

Study type

Observational

Primary location

Singapore Health Services Pte ltd

Singapore, 169856

About this study

Cohort of patients who were treated will be analysed via retrospective medical records review. These patients are classified according to the institution, type of surgical procedures, the medical condition and the dates of surgical treatment. The study will be compared across four time periods as listed:

-1Jan-31Dec2020 -1Jan-31Dec2019 -1Jan-31Dec2018 -1Jan-31Dec2017

The study focus on surgical indices for selected high-volume cancer and non-cancer diagnoses over the period 1st January 2020 to 31 December 2020 and compare them with similar indices across the same period of time in the preceding 3 years in particular, for the following surgical procedures:

Surgeries for the following cancer diagnoses:

breast cancer, [XIV- N60, no malignancy], [Malignant, II Neoplasms- C50], colorectal cancer, [C18, 19, 20],
hepatocellular carcinoma, [C22]
Selected non-cancer surgeries: a. Cholecystectomy b. Abdominal hernia repair

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

Patients who had the following surgeries during the period 01 Jan 2017 to 31 December 2020.

From the identified surgical procedure type as shown Surgeries for the following cancer-related procedures.

Breast Cancer
Colon Cancer
Liver
Rectum

Selected non-cancer surgeries.

Abdominal Wall
Gall bladder

Patients from SGH and its releated institute NCC Only local Singapore citizens

Exclusion criteria

No exclusion criteria

Treatment and study plan

Primary outcomes

Impact of measures taken to contain COVID-19 on hospital surgical care services and clinical outcomes

Time frame: 4 years

Study seeks to assess the effect of the measures taken to contain COVID 19 on patients who need surgical services measured by patient outcomes, such as, length of hospital stay (LOS), ICU stay, APACHE score, stage of cancer at surgery.

Sponsors and collaborators

Lead sponsor

Singapore Health Services

Other

Registry information

Important dates

Study start: 2020
Primary completion: 2023
Study completion: 2024
First posted: Feb 29, 2024
Registry last updated: Feb 29, 2024

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

Published trials that share one or more normalized conditions with this study.

Completed