Guven Deniz Can, Aktas Burak Yasin, Aksun Melek Seren, Ucgul Enes, Sahin Taha Koray, Yildirim Hasan Cagri, Guner Gurkan, Kertmen Neyran, Dizdar Omer, Kilickap Saadettin, Aksoy Sercan, Yalcin Suayib, Turker Alev, Uckun Fatih Mehmet, Arik Zafer
Department of Medical Oncology, Cancer Institute, Hacettepe University, Ankara, Turkey
Department of Medical Oncology, Cancer Institute, Hacettepe University, Ankara, Turkey.
BMJ Support Palliat Care. 2020 Jul 14. doi: 10.1136/bmjspcare-2020-002468.
COVID-19 pandemic could create a collateral damage to cancer care denoting disruptions in care due to a significant burden on healthcare and resource allocations. Herein, we evaluate the early changes in the inpatient and outpatient oncology clinics to take a snapshot of this collateral damage at Hacettepe University Cancer Institute.
Patients applying the outpatient clinic and outpatient palliative care (OPC) clinic for the first time and patients admitted to inpatient wards in the first 30 days after the first case of COVID-19 in Turkey were evaluated. These data were compared with data from the same time frame in the previous 3 years.
The mean number of daily new patient applications to the outpatient clinic (9.87±3.87 vs 6.43±4.03, p<0.001) and OPC clinic (3.87±1.49 vs 1.13±1.46, p<0.001) was significantly reduced compared with the previous years. While the number of inpatient admissions was similar for a month frame, the median duration of hospitalisation was significantly reduced. The frequency of hospitalisations for chemotherapy was higher than in previous years (p<0.001). By comparison, the rate of hospitalisations for palliative care (p=0.028) or elective interventional procedures (p=0.001) was significantly reduced.
In our experience, almost all domains of care were affected during the pandemic other than patients' systemic treatments. There were significant drops in the numbers of newly diagnosed patients, patients having interventional procedures and palliative care services, and these problems should be the focus points for the risk mitigation efforts for prevention of care disruptions.
新冠疫情可能对癌症护理造成附带损害,这表现为由于医疗保健和资源分配的巨大负担而导致护理中断。在此,我们评估了哈杰泰佩大学癌症研究所住院和门诊肿瘤科的早期变化,以了解这种附带损害的情况。
对首次到门诊和门诊姑息治疗(OPC)诊所就诊的患者,以及土耳其首例新冠病例出现后的前30天内入住住院病房的患者进行了评估。将这些数据与前三年同一时间框架的数据进行了比较。
与前几年相比,门诊诊所(9.87±3.87对6.43±4.03,p<0.001)和OPC诊所(3.87±1.49对1.13±1.46,p<0.001)每日新增患者就诊的平均数量显著减少。虽然一个月内住院患者的数量相似,但住院时间中位数显著缩短。化疗住院频率高于前几年(p<0.001)。相比之下,姑息治疗(p=0.028)或择期介入手术(p=0.001)的住院率显著降低。
根据我们的经验,在疫情期间,除了患者的全身治疗外,几乎所有护理领域都受到了影响。新诊断患者、接受介入手术和姑息治疗服务的患者数量大幅下降,这些问题应成为预防护理中断的风险缓解措施的重点。