Elective Surgery Halt Likely Had Minor Effect on Pandemic ICU Capacity
Reuters Health reports on the analysis of five years of New York State hospital data led by HSS anesthesiologist Stavros G. Memtsoudis, MD, PhD, MBA and published in Anesthesia & Analgesia, showing elective surgery accounts for approximately 13 percent of intensive care unit (ICU) admissions, about 59 percent of ICU stays were medical admissions, while 28 percent were emergent/urgent admissions/trauma surgery cases.
Dr. Memtsoudis said the findings suggest efforts to free up beds for COVID-19 patients by cancelling elective surgeries may have had a limited effect on expanding ICU capacity. “Despite our best efforts to increase ICU capacity through the cancellation of elective surgery, it's not actually the primary driver of ICU resource utilization."
To estimate the impact of suspending elective surgeries in mid-March 2020 during the COVID-19 pandemic, Dr. Memtsoudis and colleagues looked at 2011-2015 data from the New York Statewide Planning and Research Cooperative System (SPARCS) on statewide ICU admissions and ventilator use. Their analysis included more than 1.2 million ICU admissions, or about 10 percent of all hospital admissions. Mechanical ventilation was required in 26.3 percent of ICU admissions. Among ventilated patients, 60.8 percent were medical admissions, 32.8 percent were emergent/urgent admissions/trauma surgery, and 6.4 percent. were admitted after elective surgery. More than half of the emergent/urgent/trauma surgery admissions required more than 96 hours of invasive ventilation.
The biggest surge in ICU bed capacity in New York during the pandemic likely came from reductions in trauma and medical admissions due to stay-at-home orders, Dr. Memtsoudis noted. Nevertheless, he added, stopping elective surgery was an essential step in pandemic preparations.
Read the full Reuters Health article at Medscape.com.