Patel R, Hainsworth A J, Devlin K, Patel J H, Karim A
Department of Colorectal Surgery, St. George's Hospital, London, UK.
Imaging Department, St. George's Hospital, London, UK.
Ann R Coll Surg Engl. 2020 Jun 27;102(6):1-6. doi: 10.1308/rcsann.2020.0147.
The COVID-19 pandemic has put significant stress on healthcare systems globally. This study focuses on emergency general surgery services at a major trauma centre and teaching hospital. We aimed to identify whether the number of patients and the severity of their presentation has significantly changed since the implementation of a national lockdown.
This study is a retrospective review of acute referrals (from general practice and accident and emergency) to the emergency general surgery team over a 14-day period before (group 1) and during (group 2) lockdown.
A total of 151 patients were reviewed by the general surgical team in group 1 and 75 in group 2 (a 50.3% reduction). The number of days with symptoms prior to presentation was significantly shorter in group 1 compared with group 2 (3 vs 4, = 0.04). There was no significant difference in the National Early Warning Score, white blood cell count, lymphocytes and C-reactive protein on admission between the two groups of patients. There were significantly fewer patients admitted after lockdown compared with pre-lockdown (66% vs 48%, = 0.01). Length of hospital stay was significantly shorter during lockdown compared with pre-lockdown (5 days vs 4 days, = 0.04).
Fewer patients were referred and admitted during lockdown compared with pre-lockdown, and the length of stay was also significantly reduced. There was also a delay in presentation to hospital, although these patients were not more unwell based on the scoring criteria used within this study.
新冠疫情给全球医疗系统带来了巨大压力。本研究聚焦于一家主要创伤中心及教学医院的急诊普通外科服务。我们旨在确定自全国封锁实施以来,患者数量及其病情严重程度是否发生了显著变化。
本研究是对封锁前(第1组)和封锁期间(第2组)14天内急诊普通外科团队收到的急性转诊(来自全科医疗和急诊)进行的回顾性分析。
普通外科团队在第1组共评估了151例患者,第2组评估了75例患者(减少了50.3%)。第1组患者就诊前出现症状的天数明显短于第2组(3天对4天,P = 0.04)。两组患者入院时的国家早期预警评分、白细胞计数、淋巴细胞和C反应蛋白无显著差异。与封锁前相比,封锁后入院的患者明显减少(66%对48%,P = 0.01)。与封锁前相比,封锁期间住院时间明显缩短(5天对4天,P = 0.04)。
与封锁前相比,封锁期间转诊和入院的患者减少,住院时间也显著缩短。患者就诊也出现了延迟,尽管根据本研究使用的评分标准,这些患者病情并未更严重。