Department of Translational Medicine, Cardiac Surgery Unit, University of Campania, Luigi Vanvitelli, AORN dei Colli, Cardiac Surgery, Vincenzo Monaldi Hospital, Naples, Italy.
Cardiac Anaesthesia and Intensive Care Unit, AORN Dei Colli, Monaldi Hospital, Naples, Italy.
Eur J Cardiothorac Surg. 2021 Apr 29;59(4):901-907. doi: 10.1093/ejcts/ezaa436.
Healthcare systems worldwide have been overburdened by the coronavirus disease 2019 (COVID-19) outbreak. Accordingly, hospitals had to implement strategies to profoundly reshape both non-COVID-19 medical care and surgical activities. Knowledge about the impact of the COVID-19 pandemic on cardiac surgery practice is pivotal. The goal of the present study was to describe the changes in cardiac surgery practices during the health emergency at the national level.
A 26-question web-enabled survey including all adult cardiac surgery units in Italy was conducted to assess how their clinical practice changed during the national lockdown. Data were compared to data from the corresponding period in 2019.
All but 2 centres (94.9%) adopted specific protocols to screen patients and personnel. A significant reduction in the number of dedicated cardiac intensive care unit beds (-35.4%) and operating rooms (-29.2%), along with healthcare personnel reallocation to COVID departments (nurses -15.4%, anaesthesiologists -7.7%), was noted. Overall adult cardiac surgery volumes were dramatically reduced (1734 procedures vs 3447; P < 0.001), with a significant drop in elective procedures [580 (33.4%) vs 2420 (70.2%)].
This national survey found major changes in cardiac surgery practice as a response to the COVID-19 pandemic. This experience should lead to the development of permanent systems-based plans to face possible future pandemics. These data may effectively help policy decision-making in prioritizing healthcare resource reallocation during the ongoing pandemic and once the healthcare emergency is over.
全球医疗体系因 2019 年冠状病毒病（COVID-19）疫情而不堪重负。因此，医院必须实施策略，深刻重塑非 COVID-19 医疗保健和外科活动。了解 COVID-19 大流行对心脏外科学实践的影响至关重要。本研究的目的是描述在国家卫生紧急情况下心脏外科学实践的变化。
对意大利所有成人心脏外科单位进行了一项包含 26 个问题的网络调查，以评估其临床实践在国家封锁期间的变化。将数据与 2019 年同期的数据进行比较。
除 2 个中心（94.9%）外，所有中心都采用了特定的方案来筛查患者和医务人员。专用心脏重症监护病房床位（-35.4%）和手术室（-29.2%）数量显著减少，医疗保健人员重新分配到 COVID 部门（护士-15.4%，麻醉师-7.7%）。成人心脏手术总量明显减少（1734 例与 3447 例；P<0.001），择期手术显著减少[580 例（33.4%）与 2420 例（70.2%）]。
这项全国性调查发现，心脏外科学实践因 COVID-19 大流行而发生重大变化。这一经验应导致制定基于系统的永久性计划，以应对未来可能出现的大流行。这些数据可能在当前大流行期间和医疗紧急情况结束后有效帮助医疗资源重新分配的决策制定。
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