Postponement of elective hernia surgeries due to COVID-19 resource reallocation; potential risk of increased emergency hernia repairs
Target Population
Patients undergoing hernia repair surgeries in Sweden during 2020–2021
Care Setting
Inpatient and outpatient surgical care across Swedish healthcare regions
Key Highlights
COVID-19 pandemic caused a significant reduction in elective hernia surgeries in Sweden, especially during the first wave.
No statistically significant correlation was found between decreased elective hernia repairs and increased emergency hernia repairs within the following three months.
Sweden’s decentralized healthcare system had no national standard for elective surgery management during the pandemic.
Guideline-Based Recommendations
Diagnosis
Use ICD codes K40, K41, K42, and K43.0–K43.5 to identify hernia types for surgical planning and registry documentation.
Management
Elective hernia repairs may be postponed during healthcare resource strain without a demonstrated increase in emergency repairs within three months.
Emergency hernia repairs are identified by unplanned admissions, assumed to represent incarceration or strangulation.
Monitoring & Follow-up
Monitor elective and emergency hernia repair volumes monthly to assess impact of healthcare system changes.
Track COVID-19 case and ICU admission rates to correlate healthcare burden with surgical activity.
Risks
Risk of hernia incarceration or strangulation is greatest within three months of non-operative management decisions.
No observed increase in emergency hernia repairs despite reduced elective surgeries during the pandemic period.
Patient & Prescribing Data
Patients undergoing hernia repair surgeries in Sweden from 2016 to 2021, with focus on 2020–2021 COVID-19 period.
During the COVID-19 pandemic, 90% of hernia repairs were elective and 10% emergency; elective surgery reductions did not lead to increased emergency surgeries in the subsequent three months.
Clinical Best Practices
Utilize national patient registries for comprehensive tracking of surgical procedures and outcomes.
Consider a three-month window for monitoring emergency hernia events following postponement of elective repairs.
Maintain flexibility in surgical scheduling during pandemics while monitoring for potential increases in emergency cases.
