{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,26]],"date-time":"2026-01-26T01:08:05Z","timestamp":1769389685810,"version":"3.49.0"},"reference-count":15,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2020,9,23]],"date-time":"2020-09-23T00:00:00Z","timestamp":1600819200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["ANZ Journal of Surgery"],"published-print":{"date-parts":[[2020,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The New Zealand Government announced a four\u2010level COVID\u201019 alert system soon after the first confirmed case in the country. New Zealand moved swiftly to the highest alert level 4, described as lockdown, as the epidemic curve quickly accelerated. Auckland City Hospital saw a temporary change in acute surgical admissions. The aim of this study is to evaluate the impact of the national lockdown on emergency general surgery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective analysis was performed of all patients admitted to Auckland City Hospital via the Acute Surgical Unit during lockdown from 26 March to 27 April 2020. A comparison group was collected from the 33\u2009days prior to lockdown, 22 February to 25 March 2020.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The number of admissions decreased by 26% (<jats:italic>P<\/jats:italic>\u2010value 0.000). A 56.8% decrease in patients presenting with trauma was found (<jats:italic>P<\/jats:italic>\u2010value 0.002). After exclusion of trauma patients, no statistical difference in discharge diagnosis was found. There was a 43.6% reduction in operations performed (<jats:italic>P<\/jats:italic>\u2010value 0.037). There was a difference found in the management of appendicitis and cholecystitis (<jats:italic>P<\/jats:italic>\u2010value 0.003). Median length of stay was decreased from 1.8 to 1.3\u2009days (<jats:italic>P<\/jats:italic>\u2010value 0.031).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Auckland City Hospital had a decrease in admissions and operations during the COVID\u201019 lockdown. These findings suggest people with serious pathology were staying at home untreated or being treated in the community. This is a snapshot of our experience in managing emergency general surgical patients in this unusual period.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ans.16336","type":"journal-article","created":{"date-parts":[[2020,9,17]],"date-time":"2020-09-17T12:59:02Z","timestamp":1600347542000},"page":"2254-2258","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":38,"title":["Impact of the <scp>COVID<\/scp>\u201019 national lockdown on emergency general surgery: Auckland City Hospital's experience"],"prefix":"10.1111","volume":"90","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0842-5922","authenticated-orcid":false,"given":"Matthew J.","family":"McGuinness","sequence":"first","affiliation":[{"name":"Acute Surgical Unit Auckland City Hospital  Auckland New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Li","family":"Hsee","sequence":"additional","affiliation":[{"name":"Acute Surgical Unit Auckland City Hospital  Auckland New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2020,9,23]]},"reference":[{"key":"e_1_2_8_2_1","unstructured":"GreiveD. Ardern announces four\u2010tier Covid\u201019 alert system as NZ faces community spread.The Spinoff. 2020 March 21. [Cited 17 May 2020.] Available from URL:www.thespinoff.co.nz\/politics\/21-03-2020\/pm-ardern-announces-four-tier-covid-19-alert-system-as-nz-faces-community-spread"},{"key":"e_1_2_8_3_1","unstructured":"ArdernJ. Nation steps up to COVID\u201019 alert level 2.The NZ Government. 2020 March 21. [Cited 17 May 2020.] Available from URL:www.beehive.govt.nz\/release\/nation-steps-COVID-19-alert-level-2"},{"key":"e_1_2_8_4_1","unstructured":"NeilsonM.Covid\u201019 coronavirus: what will alert level 4 mean for NZ?The NZ Herald. 2020 March 23. [Cited 17 May 2020.] Available from URL:www.nzherald.co.nz\/nz\/news\/article.cfm?c_id=1&objectid=12319125"},{"key":"e_1_2_8_5_1","unstructured":"ArdernJ.Transcript of Prime Minister's media update 24 March 2020.The NZ Goverment. 2020 March 24. [Cited 17 May 2020.] Available from URL:www.COVID19.govt.nz\/latest\u2010updates\/update\u2010from\u2010prime\u2010minister\u2010jacinda\u2010ardern\u2010240320\/transcript\u2010of\u2010prime\u2010ministers\u2010media\u2010update\u201024\u2010march\u20102020\/"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1445-2197.2012.06141.x"},{"key":"e_1_2_8_7_1","first-page":"8","article-title":"COVID\u201019\u2010the frontline (a GP perspective)","volume":"133","author":"Baddock K","year":"2020","journal-title":"N. Z. Med. J."},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMc2009166"},{"key":"e_1_2_8_9_1","first-page":"81","article-title":"Variation in volumes and characteristics of trauma patients admitted to a level one trauma centre during national level 4 lockdown for COVID\u201019 in NZ","volume":"133","author":"Christey G","year":"2020","journal-title":"N. Z. Med. J."},{"key":"e_1_2_8_10_1","unstructured":"CunninghamC NoyesJ. Locked\u2010down lives drive emergency department numbers to record lows.The Sunday Morning Herlad. 2020 April 21. [Cited 17 May 2020.] Available from URL:www.smh.com.au\/national\/locked\u2010down\u2010lives\u2010drive\u2010emergency\u2010department\u2010numbers\u2010to\u2010record\u2010lows\u201020200420\u2010p54lcc.html"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.m1401"},{"key":"e_1_2_8_12_1","unstructured":"FeuerW. Doctors worry the coronavirus is keeping patients away from US hospitals as ER visits drop: \u2018Heart attacks don't stop\u2019.CNBC. 2020 April 14. [Cited 17 May 2020.] Available from URL:www.cnbc.com\/2020\/04\/14\/doctors-worry-the-coronavirus-is-keeping-patients-away-from-us-hospitals-as-er-visits-drop-heart-attacks-dont-stop.html"},{"key":"e_1_2_8_13_1","unstructured":"FlahiveB AndersonR. Coronavirus: Why the PM's repeated 'stay at home' message appears to be working.Stuff. 2020 April 01. [Cited 17 May 2020.] Available from URL:www.stuff.co.nz\/national\/politics\/120696983\/coronavirus\u2010why\u2010the\u2010pms\u2010repeated\u2010stay\u2010at\u2010home\u2010message\u2010appears\u2010to\u2010be\u2010working"},{"key":"e_1_2_8_14_1","unstructured":"Royal College of Surgeons of England.Intercollegiate General Surgery Guidance on COVID\u201019. Royal College of Surgeons of England. 2020. [Cited 17 May 2020.] Available from URL:www.rcseng.ac.uk\/coronavirus\/joint-guidance-for-surgeons-v2:"},{"key":"e_1_2_8_15_1","unstructured":"CollinsonT Sayed\u2010HassenAH SpeightJ BannS.COVID\u201019 Guidelines for General Surgery. General Surgeons Australia & RACS Australian Board in General Surgery and NZ Association of General Surgeons & RACS NZ Board in General Surgery. 2020 March 31. [Cited 17 May 2020.] Available from URL:https:\/\/umbraco.surgeons.org\/media\/5160\/doc\u20102020\u201003\u201031\u2010covid\u201019\u2010guidelines\u2010for\u2010general\u2010surgery_final_updated.pdf"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.11670"}],"container-title":["ANZ Journal of Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ans.16336","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/ans.16336","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ans.16336","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,4]],"date-time":"2023-09-04T23:06:52Z","timestamp":1693868812000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/ans.16336"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,9,23]]},"references-count":15,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2020,11]]}},"alternative-id":["10.1111\/ans.16336"],"URL":"https:\/\/doi.org\/10.1111\/ans.16336","archive":["Portico"],"relation":{},"ISSN":["1445-1433","1445-2197"],"issn-type":[{"value":"1445-1433","type":"print"},{"value":"1445-2197","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,9,23]]},"assertion":[{"value":"2020-05-18","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-09-04","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-09-23","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}