Stöß Christian, Steffani Marcella, Kohlhaw Kay, Rudroff Claudia, Staib Ludger, Hartmann Daniel, Friess Helmut, Müller Michael W
Department of Surgery, Klinikum rechts der Isar, Technical University of Munich, School of Medicine, Ismaninger St 22, 81675, Munich, Germany.
Clinic of General, Visceral, MIS and Vascular Surgery, Clinical Centre Borna, Borna, Germany.
BMC Surg. 2020 Dec 3;20(1):313. doi: 10.1186/s12893-020-00970-x.
During the first wave of the COVID-19 pandemic, German health care centres were restructured for the treatment of COVID-19 patients. This was accompanied by the suspension of the surgical programme. The aim of the survey was to determine the effects of COVID-19 on surgical care in non-university hospitals in Germany.
This cross-sectional study was based on an anonymous online survey, which was accessible from April 24th to May 10th, 2020 for surgeons of the Konvent der leitenden Krankenhauschirurgen (Convention of leading Hospital Surgeons) in Germany. The analysis comprised of 22.8% (n = 148/649) completed surveys.
Communication and cooperation with authorities, hospital administration and other departments were largely considered sufficient. In the early phase of the COVID-19 pandemic, 28.4% (n = 42/148) of the respondents complained about a short supply of protective equipment available for the hospital staff. 7.4% (n = 11/148) of the participants stated that emergency operations had to be postponed or rescheduled. A decreased quantity of emergency surgical procedures and a decreased number of surgical emergency patients treated in the emergency room was reported in 43.9% (n = 65/148) and 63.5% (n = 94/148), respectively. Consultation and treatment of oncological patients in the outpatient clinic was decreased in 54.1% (n = 80/148) of the surveyed hospitals. To increase the capacity for COVID-19 patients, a reduction of bed and operating room occupancy of 50.8 ± 19.3% and 54.2 ± 19.1% were reported, respectively. Therefore, 90.5% (n = 134/148) of all participants expected a loss of revenue of 28.2 ± 12.9% in 2020.
The first wave of the COVID-19 pandemic had a significant impact on surgical care in Germany. The reduction in the bed and the operating room capacity may have lead to considerable delays in urgent and semi-elective surgical interventions. In addition to the risk of worsening patient care, we anticipate severe financial damage to the clinics in 2020 and beyond. National and supranational planning is urgently needed to ensure the surgical care of patients during the ongoing COVID-19 pandemic.
在新冠疫情的第一波期间，德国的医疗保健中心为治疗新冠患者进行了重组。这伴随着外科手术计划的暂停。该调查的目的是确定新冠疫情对德国非大学医院外科护理的影响。
这项横断面研究基于一项匿名在线调查，2020年4月24日至5月10日期间，德国领先医院外科医生大会的外科医生可参与该调查。分析包括22.8%（n = 148/649）的完成调查。
与当局、医院管理部门和其他科室的沟通与合作在很大程度上被认为是充分的。在新冠疫情的早期阶段，28.4%（n = 42/148）的受访者抱怨医院工作人员可用的防护设备短缺。7.4%（n = 11/148）的参与者表示急诊手术不得不推迟或重新安排。据报告，43.9%（n = 65/148）的急诊外科手术数量减少，63.5%（n = 94/148）的急诊室治疗的外科急诊患者数量减少。54.1%（n = 80/148）的受访医院门诊肿瘤患者的咨询和治疗减少。为了增加收治新冠患者的能力，报告称床位和手术室占用率分别降低了50.8±19.3%和54.2±19.1%。因此，90.5%（n = 134/148）的所有参与者预计2020年的收入损失为28.2±12.9%。
新冠疫情的第一波对德国的外科护理产生了重大影响。床位和手术室容量的减少可能导致紧急和半择期外科手术干预出现相当大的延迟。除了患者护理恶化的风险外，我们预计2020年及以后诊所将遭受严重的经济损失。迫切需要国家和超国家层面的规划，以确保在持续的新冠疫情期间为患者提供外科护理。
