Surgical Critical Care Outcomes Before and After the Onset of the COVID-19 Pandemic: A Single-Center Retrospective Comparative Audit

This audit aimed to determine whether the pattern of presenting abdominal pathology, procedures performed, and clinical outcomes in our surgical intensive care unit (SICU) changed during the COVID-19 period. We reviewed a total of 356 patients who were admitted to the SICU with 1st March 2020 taken as the reference cutoff date. Two hundred and five (57.6%) cases occurred in the Pre-COVID interval and 151 (42.4%) in the Post-COVID interval. Patients admitted to SICU Post-COVID were significantly older than those admitted Pre-COVID (54.2 vs. 48.3 years, p = 0.005). Hospital and SICU length of stay were unchanged across the pandemic (p = 0.824 and 0.601 respectively). The procedure case-mix shifted significantly (p = 0.014): appendectomy, gastrectomy/sleeve gastrectomy and thoracic procedures fell, while exploratory laparotomy rose, consistent with reduced elective/minimally-invasive activity and a shift toward emergency open surgery. Appendiceal disease was recorded significantly less often as the presenting diagnosis Post-COVID (p = 0.016), and intestinal obstruction showed a non-significant upward trend (p = 0.071). SICU mortality and overall admission outcome were unchanged across the pandemic (p = 1.000 and 0.664).