确诊的 2019 冠状病毒病（COVID-19）感染对非住院患者的门诊程序和相关的无症状患者护理延迟的影响。
The impact of confirmed coronavirus disease 2019 (COVID-19) infection on ambulatory procedures and associated delays in care for asymptomatic patients.
机构信息
Northwell Health Department of Orthopedic Surgery, North Shore-Long Island Jewish Medical Center Residency Program, New Hyde Park, NY; Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY.
Northwell Health Department of Orthopedic Surgery, North Shore-Long Island Jewish Medical Center Residency Program, New Hyde Park, NY; Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY.
出版信息
Surgery. 2021 Jun;169(6):1340-1345. doi: 10.1016/j.surg.2021.01.005. Epub 2021 Jan 20.
BACKGROUND
Since the reopening of ambulatory centers, minimal data has been reported regarding positive tests among patients undergoing ambulatory procedures, associated delays in care, and outcomes of patients previously positive for coronavirus disease 2019.
METHODS
A retrospective observational case series of ambulatory procedures was performed. Records since the reopening of ambulatory centers in New York were searched for patients with positive coronavirus disease 2019 nasal swab results who underwent ambulatory procedures. Chart reviews were conducted to determine coronavirus disease history and hospitalizations, demographic information, procedure details, and 30-day admissions.
RESULTS
A total of 3,762 patients underwent ambulatory procedures. Of those, 53 were previously diagnosed with coronavirus disease 2019 but recovered and tested negative at preprocedural testing. Of the 3,709 asymptomatic patients, 37 (1.00%) tested positive during preprocedural testing; 21 patients had their procedures delayed on average 28.6 days until testing negative, while 16 had their procedures performed before testing negative owing to the time sensitivity of the procedure. There were no major complications or 30-day admissions in any of these asymptomatic patients. Three patients tested positive for coronavirus disease after having an ambulatory procedure.
CONCLUSION
Positive tests in asymptomatic patients led to procedure delays of 28.6 days. No patients who underwent ambulatory procedures after a positive coronavirus disease 2019 test had any coronavirus disease-related complications, regardless of whether or not the procedure was delayed until testing negative. Three patients tested positive for coronavirus disease 2019 after having an ambulatory procedure; however, at an average of 19.7 days after, these cases were likely community acquired making the rate of nosocomial infection negligible.
背景
自门诊中心重新开放以来，关于接受门诊手术的患者中阳性检测结果、相关医疗延误以及先前新冠病毒检测阳性患者的结局，仅有少量数据报道。
方法
我们开展了一项回顾性观察性门诊手术病例系列研究。自纽约门诊中心重新开放以来，我们检索了门诊鼻咽拭子新冠病毒检测结果阳性、接受门诊手术的患者记录。通过病历回顾，确定新冠病毒感染史和住院情况、人口统计学信息、手术细节以及 30 天内再入院情况。
结果
共有 3762 例患者接受了门诊手术。其中 53 例患者先前被诊断为新冠病毒感染但已康复且术前检测结果为阴性。在 3709 例无症状患者中，37 例（1.00%）在术前检测中呈阳性；21 例患者的手术平均延迟 28.6 天，直至检测结果转为阴性，而 16 例患者在检测结果转为阴性之前进行了手术，因为手术具有时间敏感性。在这些无症状患者中，没有出现任何重大并发症或 30 天内再入院。有 3 例患者在接受门诊手术后新冠病毒检测结果呈阳性。
结论
无症状患者的阳性检测结果导致手术延迟 28.6 天。无论手术是否延迟至检测结果转为阴性，所有接受门诊手术后新冠病毒相关并发症的患者均未出现。有 3 例患者在接受门诊手术后新冠病毒检测结果呈阳性；然而，平均在 19.7 天后，这些病例很可能是社区获得性感染，使得医院感染率可忽略不计。
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