{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T11:14:52Z","timestamp":1788347692300,"version":"build-2803163510"},"reference-count":28,"publisher":"Wiley","issue":"7-8","license":[{"start":{"date-parts":[[2026,5,19]],"date-time":"2026-05-19T00:00:00Z","timestamp":1779148800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,5,19]],"date-time":"2026-05-19T00:00:00Z","timestamp":1779148800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["ANZ Journal of Surgery"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>The effect of COVID\u201019 lockdown periods on surgical admission patterns in the Australian healthcare system has been relatively unexplored. The impact of these lockdowns was investigated via analysis of a surgical mortality dataset.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>\n                      All cases that had completed the evaluation process by 4 March 2025 (patient death between 1 January 2017 and 31 December 2024,\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200928\u2009685) were included. The ANZASM database captures deaths during surgical admissions, not all surgical admissions. Data from NSW were unavailable at the time of extraction. Cases were grouped into three cohorts, according to date of patient death: pre\u2010COVID (2017\u20132019), COVID (2020\u20132021) and post\u2010COVID (2022\u20132024).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Demographics were consistent across cohorts, with minor differences between pre\u2010 and post\u2010COVID for age (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05), length of stay (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05) and ASA score (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Differences were observed in admission patterns (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). There was a 3.9% decrease in private hospital admissions between pre\u2010 and post\u2010COVID (19.1% vs. 15.2%), contrasting with a 4.3% increase in public hospital admissions (79.4% vs. 83.7%). Similarly, there was a decrease in elective procedures between pre\u2010 and post\u2010COVID (18.5% vs. 12.9%) and an increase in \u2018scheduled emergency\u2019 procedures (i.e., &gt;\u200924\u2009h post\u2010admission) (29.7% vs. 33.1%). While there was an overall decrease in postoperative complications post\u2010COVID, there was an increase in the occurrence of anastomotic leaks. There was an increase in palliative care observed between pre\u2010 and post\u2010COVID (2.2% vs. 4.1%;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>These data indicate lasting shifts in surgical care patterns following the COVID\u201019 pandemic. The increase in admissions for palliative care under surgery post\u2010COVID could indicate that disease states customarily amenable to surgical intervention had progressed due to delayed diagnosis and COVID\u2010associated shutdowns of elective theatre activity. The increased occurrence of anastomotic leaks post\u2010COVID may reflect skill fatigue, but other potential explanations for this observation also warrant further investigation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ans.70732","type":"journal-article","created":{"date-parts":[[2026,5,19]],"date-time":"2026-05-19T12:26:41Z","timestamp":1779193601000},"page":"2158-2164","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Changes in Surgical Admissions and Outcomes During and After the\n                    <scp>COVID<\/scp>\n                    \u201019 Pandemic: An Exploration of the Australian and New Zealand Audit of Surgical Mortality (\n                    <scp>ANZASM<\/scp>\n                    )"],"prefix":"10.1111","volume":"96","author":[{"given":"Dharan A.","family":"Shah","sequence":"first","affiliation":[{"name":"School of Public Health University of Adelaide  Adelaide South Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nathan E. K.","family":"Procter","sequence":"additional","affiliation":[{"name":"Royal Australasian College of Surgeons  Adelaide South Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helena S.","family":"Kopunic","sequence":"additional","affiliation":[{"name":"Royal Australasian College of Surgeons  Adelaide South Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3482-3916","authenticated-orcid":false,"given":"Matthias W.","family":"Wichmann","sequence":"additional","affiliation":[{"name":"Department of General Surgery Mount Gambier and Districts Health Service  Mount Gambier South Australia Australia"},{"name":"The University of Adelaide  Adelaide South Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2064-181X","authenticated-orcid":false,"given":"Guy","family":"Maddern","sequence":"additional","affiliation":[{"name":"The University of Adelaide  Adelaide South Australia Australia"},{"name":"Department of Surgery the Queen Elizabeth Hospital  Woodville South Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,5,19]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1177\/0890117120930536b"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/jgs.17805"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1177\/21514593241273124"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/XCS.0000000000001042"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/bju.16652"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/hpm.3326"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm6936a4"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvsv.2021.01.002"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000004811"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13017-021-00382-z"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjsurg.2020.12.015"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph192315660"},{"key":"e_1_2_9_14_1","article-title":"SARS\u2010CoV\u20102 Impact on Elective Orthopaedic Surgery: Implications for Post\u2010Pandemic Recovery","volume":"102","author":"Jain A.","year":"2020","journal-title":"Journal of Bone and Joint Surgery. 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