Impact of COVID-19 on General Surgical Emergencies in a Tertiary Care Public Hospital in Malaysia

Introduction:COVID-19 pandemic placed unprecedented strain on hospital resources and manpower.This study assesses the impact of Malaysia's nationwide lockdown on the incidence, types, severity, and outcomes of emergency general surgery (EGS) cases at a tertiary care hospital.Methods: This retrospective cohort study analysed the data of patients who underwent EGS procedures for the period 2017 and 2021.Results: During the pandemic period, there was a 48.3% reduction in EGS cases (n=889) compared to the pre-pandemic period (n=1720).Significant reductions were observed in surgeries for appendicitis, soft tissue infection, colorectal, urology, peptic ulcer, and vascular disorders in the COVID period.Conversely, procedures for biliary disorders and hernia complications increased by 7.4% and 5.5%, respectively.Length of hospital stay increased by 57.8% for patients with small bowel disorders, while ICU/HDU admissions rose by 43.5% for colorectal cases (P < 0.05).There was no significant difference in mortality rates between the two periods. Conclusions:The overall reduction in EGS procedures during the COVID-19 period was consistent with global trends.Despite the challenges posed by the pandemic, the outcomes related to duration of stay, ICU/HDU utilisation, and mortality remained comparable to the pre-pandemic period.These findings highlight the adaptability of healthcare professionals in maintaining continuity and quality of emergency surgical care during a crisis.