The results of a recent survey showed hundreds of ambulatory surgery centers (ASCs) continued performing outpatient procedures during the initial weeks of the COVID-19 pandemic with little harm to patients.

The ASC Quality Collaboration surveyed 709 ASCs in eight states about outpatient surgical procedures performed on 84,446 patients in March and April 2020. The survey revealed only 16 patients tested positive for COVID-19 within 14 days after the procedure. Of these, two required hospitalization.

“Together with the additional COVID-19 safety measures ASCs have in place today, including heightened preoperative screenings, additional sanitary measures, and air filtration protocols, ASCs can maintain a safe, sanitary environment to treat patients, while keeping the health professionals providing their care protected,” Ann Shimek, executive director of the ASC Quality Collaboration, said in a statement.1

These are promising data, but eight states represent a limited sample size. Also, there appear to be little if any data from the six months since April. Further, the ASC Quality Collaboration noted it is unknown how or when the 16 patients tested positive for the virus (i.e., Were they already positive before surgery? Did they contract the virus days after their procedure?).

Another study2 showed COVID-19 infection was associated with a 23.8% mortality rate among surgery patients within 30 days after surgery, as reported in the August 2020 issue of Same-Day Surgery. The international, multicenter, observational cohort investigation included 1,128 patients with SARS-CoV-2 infection who underwent surgery at 235 hospitals in 24 countries. Overall, 268 patients died within 30 days after surgery. More than half of patients experienced pulmonary complications, and these patients accounted for 82.6% of all deaths.

Investigators incorporated data on different types of surgeries, including elective procedures and emergency surgery. About three-fourths of the surgeries were emergency cases, and one-fourth were elective surgeries. Procedures included head and neck, cardiac, gastrointestinal, OB/GYN, neurosurgery, ophthalmology, orthopedics, thoracic, and others. The cohort of cases included about 32% of emergency surgery patients who received a preoperative SARS-CoV-2 diagnosis and 66% who were diagnosed after surgery. Data were missing for some patients. (Read more here.)

It is unknown (and may never be) just how many ASCs and hospital outpatient departments carried out normal operations throughout the COVID-19 pandemic and which facilities closed for a period.

In the May 2020 issue of Same-Day Surgery, several sources explained some changes their facilities had made during the initial pandemic period. (Read more here.)

In a three-part question and answer series published in the June 2020 issue of Same-Day Surgery, dozens of surgery center administrators and directors from across the United States were asked about their facilities’ experiences during the pandemic’s early weeks. The leaders talked about their region’s outbreaks, their decisions, and how the emergency affected their work and operations. They spoke candidly about difficult staffing decisions but also shared lessons learned, providing hope the industry can prepare better for the next emergency. (Read more here.)

REFERENCES

  1. ASC Quality Collaboration. Ambulatory surgery centers performed essential outpatient surgeries safely during the first months of the pandemic, survey finds. Oct. 8, 2020.
  2. COVIDSurg Collaborative. Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: An international cohort study. Lancet 2020;396:27-38.