Stöver T, Dazert S, Hoffmann T K, Plontke S K, Ambrosch P, Arens C, Betz C, Beutner D, Bohr C, Bruchhage K-L, Canis M, Dietz A, Guntinas-Lichius O, Hagen R, Hosemann W, Iro H, Klussmann J-P, Knopf A, Kramer S, Lang S, Leinung M, Lenarz T, Löwenheim H, Matthias C, Mlynski R, Olze H, Park J, Plinkert P, Radeloff A, Rotter N, Rudack C, Bozzato A, Schipper J, Schrader M, Strieth S, Stuck B A, Volkenstein S, Westhofen M, Wolf G, Wollenberg B, Zahnert T, Zenk J
Klinik für Hals-Nasen-Ohrenheilkunde, Universitätsklinikum Frankfurt a. M.
Klinik für Hals-Nasen-Ohrenheilkunde, Ruhr-Universität-Bochum, St. Elisabeth-Hospital.
Laryngorhinootologie. 2020 Oct;99(10):694-706. doi: 10.1055/a-1232-4911. Epub 2020 Aug 6.
Since December 2019, the SARS-CoV-2 virus has been rapidly spreading worldwide. In Germany, an exponential increase in the number of infections was registered at the beginning of March 2020 and led to a call of the Ministry of Health to create more capacity for intensive medical treatment in hospitals. The aim of the present study was to determine the effects of the SARS-CoV-2 pandemic on Oto-Rhino-Laryngology (ORL) university hospitals regarding patient care.
An online survey was sent out to all chairmen of the 39 ORL university hospitals in Germany. The answers to the questions referred to the defined period from March 15 to April 15 2020 and were carried out using the online survey tool "SurveyMonkey". 87 questions focused on general information, health care, and structural effects in the respective institution.
All chairmen of the 39 university hospitals in Germany participated in the survey. The collected data prove the considerable impact on organizational, structural and medical aspects of patient care. For example, the surveyed clinics reported a decrease in outpatient cases by 73.8 % to 26.2 ± 14.2 % and in surgical treatments by 65.9 % to 34.1 ± 13.9 %. In contrast, emergency treatment remained unchanged or even increased in 80 % of the facilities and surgical treatment of emergency patients remained unchanged or even increased in more than 90 %. Emergency outpatient and surgical treatment of patients was provided throughout the pandemic in all facilities. In total, about 35 000 outpatients and about 12 000 surgical cases were postponed. As a result of the acute structural changes, the potential danger of falling below current treatment standards was seen in individual areas of patient care.
The assessment of the impact of the SARS-CoV-2 pandemic is heterogeneous. The majority of the chairmen are critically aware of the risk of falling below current medical treatment standards or guidelines. In the phase of an exponential increase in the number of infections, significant changes in treatment processes had to be accepted for understandable reasons. However, with the currently significantly reduced number of infections, falling below treatment standards and guidelines should not be allowed to remain constant and tolerated.
This study shows a differentiated picture with regard to the effects of the SARS-CoV-2 pandemic on outpatient, inpatient and operative patient care at the ORL university hospitals in Germany and illustrates the importance of these institutions for ensuring patient care during this critical phase.
自2019年12月以来，严重急性呼吸综合征冠状病毒2（SARS-CoV-2）病毒在全球迅速传播。在德国，2020年3月初感染人数呈指数级增长，导致卫生部呼吁医院增加重症医疗救治能力。本研究的目的是确定SARS-CoV-2大流行对耳鼻喉科（ORL）大学医院患者护理的影响。
向德国39家ORL大学医院的所有主任发送了一份在线调查问卷。问题的答案涉及2020年3月15日至4月15日的规定时间段，使用在线调查工具“SurveyMonkey”进行调查。87个问题聚焦于各机构的一般信息、医疗保健和结构影响。
德国39家大学医院的所有主任都参与了调查。收集的数据证明了对患者护理的组织、结构和医疗方面产生了重大影响。例如，接受调查的诊所报告门诊病例减少了73.8%，降至26.2±14.2%，手术治疗减少了65.9%，降至34.1±13.9%。相比之下，80%的机构急诊治疗保持不变甚至增加，90%以上的机构急诊患者的手术治疗保持不变甚至增加。在整个大流行期间，所有机构都提供了患者的急诊门诊和手术治疗。总共约35000名门诊患者和约12000例手术病例被推迟。由于急性结构变化，在患者护理的个别领域出现了低于当前治疗标准的潜在风险。
对SARS-CoV-2大流行影响的评估是多方面的。大多数主任都敏锐地意识到低于当前医疗治疗标准或指南的风险。在感染人数呈指数级增长阶段，出于可以理解的原因，不得不接受治疗过程中的重大变化。然而，随着目前感染人数大幅减少，不应允许低于治疗标准和指南的情况持续存在并被容忍。
本研究显示了SARS-CoV-2大流行对德国ORL大学医院门诊、住院和手术患者护理影响的不同情况，并说明了这些机构在这一关键阶段确保患者护理的重要性。
