Cicerello Elisa, Mangano Mario S, Cova Giandavide, Zordani Alessio
Urology Unit, Department of Surgery, Ca' Foncello Hospital, Treviso.
Arch Ital Urol Androl. 2020 Dec 17;92(4). doi: 10.4081/aiua.2020.4.282.
The Coronavirus Disease (COVID-19) is causing a significant health emergency which is overturning dramatically routine activities in hospitals. The outbreak is generating the need to provide assistance to infected patients and in parallel to treat all nondeferrable oncological and urgent benign diseases. A panel of Italian urologists agreed on possible strategies for the reorganization of urological routine practices and on a set of recommendations that should facilitate a further planning of both inpatient visits and surgical activities during the COVID- 19 pandemic. According to this only urgent benign and nondeferrable oncological activities have been kept.
We have considered urgent outpatient visits requested by Emergency Department (ED) or by General Practitioner (GP) and emergency surgical procedures performed in our Urology Unit from March 9th to April 14th 2020, during COVID-19 pandemic. These figures have been compared to those observed last year from March 9th to April 14th 2019.
Our data show that urgent care visits decreased during COCID-19 pandemic (from 293 to 179). Urgent care visits of patients who accessed directly to the ED decreased (from 219 to 107) whereas the number of urgent care visits referred by GP remained unchanged (74 vs 72). Consequently, the rate of visits from ED decreased from 75% to 60% and the rate of visit requested by GP increased from 25% to 40% (p = 0.001). Particularly, the rate of visits for renal colic, LUTS and other not precisely defined disorders from ED decreased and the corresponding rates of visits of patients referred by GPs increased significantly (p = 0.0001, p = 0.0180 and p = 0.0185, respectively). The rate of visits for acute urinary retention, hematuria, sepsis, acute scrotum, cystitis, prostatitis and genito-urinary trauma from ED and GP remained unchanged. Finally, urgency endourology and surgical activities have been stable in relation to the same period last year.
Urological emergency activities during COVID- 19 pandemic are more appropriate since urgent outpatients' visits required by ED are decreased and emergency surgical and endourological procedures are stable.
冠状病毒病（COVID-19）正在引发一场重大的健康紧急事件，极大地颠覆了医院的日常活动。此次疫情使得有必要为感染患者提供援助，同时治疗所有不能推迟的肿瘤疾病和紧急良性疾病。一组意大利泌尿科医生就泌尿外科日常诊疗活动的重组可能策略以及一系列建议达成了共识，这些建议应有助于在COVID-19大流行期间进一步规划住院患者就诊和手术活动。据此，仅保留了紧急良性和不能推迟的肿瘤相关活动。
我们统计了2020年3月9日至4月14日COVID-19大流行期间，急诊科（ED）或全科医生（GP）要求的紧急门诊就诊情况，以及我们泌尿外科进行的急诊手术程序。这些数据与2019年3月9日至4月14日观察到的数据进行了比较。
我们的数据显示，在COVID-19大流行期间，紧急护理就诊次数减少（从293次降至179次）。直接前往急诊科的患者的紧急护理就诊次数减少（从219次降至107次），而全科医生转诊的紧急护理就诊次数保持不变（74次对72次）。因此，来自急诊科的就诊率从75%降至60%，全科医生要求的就诊率从25%升至40%（p = 0.001）。特别是，急诊科因肾绞痛、下尿路症状（LUTS）和其他未明确界定的疾病的就诊率下降，而全科医生转诊患者的相应就诊率显著上升（分别为p = 0.0001、p = 0.0180和p = 0.0185）。急诊科和全科医生因急性尿潴留、血尿、脓毒症、急性阴囊炎、膀胱炎、前列腺炎和泌尿生殖系统创伤的就诊率保持不变。最后，与去年同期相比，急诊泌尿外科和手术活动保持稳定。
在COVID-19大流行期间，泌尿外科急诊活动更为合理，因为急诊科要求的紧急门诊就诊次数减少，急诊手术和泌尿外科手术程序保持稳定。
