Background: The Covid19 pandemic significantly disrupted the treatment of hospital patients with other diseases due to the priority engagement of human and material resources in the treatment of COVID-19 patients. The extent to which this disorder affected the case fatality rate of non-COVID-19 patients has not yet been investigated in detail. Objective: The aim of this study was to compare the in-hospital lethality of non-COVID-19 patients before and during the COVID-19 pandemic, as well as to identify factors with a possible impact on lethality. Methods: Case fatality rates (total and in the first 48 hours) were collected from the Information system of the University Clinical Center Kragujevac, Serbia, for the period from 2017 to 2021, both for the institution as a whole and for internal medicine, surgery, gynecology and pediatrics. The trends are presented graphically, and their significance was examined by Mann-Kendall's trend test. Results: There was no significant trend in case fatality rate at the level of the entire institution, but with the onset of the pandemic, there was a significant shortening of hospital stays (from 6.26 to 4.48 days on average). Case fatality rate in the first 48 hours increased significantly in patients of surgical disciplines with the onset of a pandemic, while the case fatality rate in the first 48 hours and overall case fatality rate decreased significantly in patients of internal medicine disciplines. In pediatric patients, there was an increase in the case fatality rate with the onset of the pandemic, both in total and calculated for the first 48 hours of hospitalization. There were no changes in case fatality rate in gynecological patients. Conclusion: Due to the burden caused by the COVID19 pandemic in tertiary health care institutions, non-COVID-19 patients from vulnerable groups–surgical and pediatric–have adverse consequences. For such patient groups administrative restrictions of access to hospital care during pandemics should be avoided, since delayed diagnostics and treatment increase mortality.
Key words: non-COVID-19 inpatients, case fatality rate, emergency surgery.
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