Göksoy Beslen, Akça Muhammed Tahir, Inanç Ömer Faruk
Department of General Surgery, Şehit Prof. Dr. İlhan Varank Sancaktepe Training and Research Hospital, İstanbul-Turkey.
Ulus Travma Acil Cerrahi Derg. 2020 Sep;26(5):685-692. doi: 10.14744/etd.2020.67927.
The novel Coronavirus Disease 2019 (COVID-19) formed the basis for emergency department visits. This study aims to evaluate the effects of the pandemic on emergency department visits of surgical patients.
The hospital database records of general surgery patients who presented at the emergency department in the period of March 2020-May 2020 (pandemic period) and March 2019-May 2019 (non-pandemic period) were retrospectively analyzed and compared. The primary outcome of this study was the emergency department visit rate of patients requiring a general surgery consultation. Secondary outcomes of this study were patient complaints, diagnosis and treatments, treatment rejection rate, triage category data, the effects of age and gender, and the hospitalization rate.
In this study, 618 patients were included: 265 patients from the pandemic period and 353 patients from the non-pandemic period. The analysis and comparison revealed that during the pandemic period, the presentation rate of female patients was lower than that of male patients (45.5% vs. 55.5%, respectively, p=0.045). The triage category rates of patient visits to the hospital during the pandemic period were higher in yellow and red, and lower in green (p<0.01). The incidence of a surgical pathology finding was higher during the pandemic period (p=0.019). The incidence of diseases related to the gastrointestinal tract was higher during the pandemic period (p=0.011). The rate of open surgery in the pandemic period was higher than that of the non-pandemic period (80.5% vs. 32.7%, respectively; p<0.01). The treatment rejection rate was also higher in the pandemic period compared with the non-pandemic period (20% vs. 3.7%, respectively; p<0.01, r). In addition, the hospitalization period was shorter in the pandemic period (p=0.021).
A 25% reduction in the number of surgical patient visits to the emergency department was observed during the COVID-19 outbreak. The biggest decrease was seen in patients with a green triage code and female patients. It is significant to evaluate the effects of the pandemic on surgical patients visited the emergency department to manage the post-epidemic period and to prepare for possible future epidemic periods.
2019年新型冠状病毒病（COVID-19）是急诊科就诊的基础。本研究旨在评估疫情对手术患者急诊科就诊的影响。
回顾性分析并比较2020年3月至2020年5月（疫情期间）和2019年3月至2019年5月（非疫情期间）在急诊科就诊的普通外科患者的医院数据库记录。本研究的主要结局是需要普通外科会诊的患者的急诊科就诊率。本研究的次要结局包括患者投诉、诊断与治疗、治疗拒绝率、分诊类别数据、年龄和性别的影响以及住院率。
本研究纳入618例患者，其中疫情期间265例，非疫情期间353例。分析比较发现，疫情期间女性患者的就诊率低于男性患者（分别为45.5%和55.5%，p= =0.045）。疫情期间患者到医院就诊的黄色和红色分诊类别率较高，绿色分诊类别率较低（p<0.01）。疫情期间手术病理发现的发生率较高（p=0.019）。疫情期间胃肠道相关疾病的发生率较高（p=0.011）。疫情期间开放手术率高于非疫情期间（分别为80.5%和32.7%；p<0.01）。与非疫情期间相比，疫情期间的治疗拒绝率也更高（分别为20%和3.7%；p<0.01，r）。此外，疫情期间住院时间较短（p=0.021）。
在COVID-19疫情爆发期间，观察到手术患者到急诊科就诊的人数减少了25%。绿色分诊代码患者和女性患者的减少幅度最大。评估疫情对到急诊科就诊的手术患者的影响对于管理疫情后时期以及为未来可能的疫情时期做准备具有重要意义。
