Impact of COVID-19 on Scheduled and Emergency Hernia Surgeries in Sweden

Overview

The COVID-19 pandemic significantly reduced the number of elective hernia surgeries in Sweden, particularly during the first wave. Despite this reduction, there was no statistically significant increase in emergency hernia repairs in the subsequent three months.

Background

The COVID-19 pandemic imposed substantial strain on healthcare systems worldwide, leading to postponement of many elective surgeries. Sweden's approach differed by avoiding a nationwide lockdown, but still experienced resource reallocation affecting surgical procedures. Hernia repairs, both planned and emergency, provide a useful measure to assess the pandemic's impact on surgical care. This study analyzed registry data from 2016 to 2021 to evaluate whether decreased elective hernia surgeries during the pandemic led to increased emergency cases.

Data Highlights

Key Findings

• A total of 34,737 hernia repairs were performed during the COVID-19 period, with 90% being planned and 10% emergency repairs.
• There was a marked reduction in elective hernia surgeries during the pandemic compared to the pre-pandemic period.
• No statistically significant correlation was found between the number of elective hernia repairs in a given month and emergency repairs in the following three months for any hernia type.
• Pearson correlation coefficients for elective versus emergency repairs were not significant across inguinal, femoral, umbilical, and incisional hernias (p-values all > 0.1).
• The first wave of COVID-19 caused the greatest burden on healthcare resources, reflected in ICU admissions and reduced elective surgeries.

Clinical Implications

Clinicians can be reassured that postponing elective hernia repairs during pandemic-related healthcare disruptions did not lead to a measurable increase in emergency hernia surgeries within three months. This suggests that temporary delays in elective hernia surgery may be safe in similar crisis contexts. However, continued monitoring is essential to detect any long-term adverse outcomes from deferred surgical care.

Conclusion

The COVID-19 pandemic significantly impacted elective hernia surgery volumes in Sweden, but this did not translate into increased emergency hernia repairs in the short term. These findings support the safety of temporary postponement of elective hernia procedures during healthcare crises.

References

1. Swedish National Patient Register -- Data Source
2. Ewing et al. 2021 -- Impact of COVID-19 on Hernia Surgery in Scotland
3. Swedish Department of Public Health -- COVID-19 Case Data