Li Zhen, Jiang Yu, Yu Yang, Kang Qianyu
Department of Urology, The Fifth People's Hospital of Dalian, Dalian, Liaoning, People's Republic of China.
Department of Pediatrics, Dalian Municipal Women and Children's Medical Center, Dalian, Liaoning, People's Republic of China.
Risk Manag Healthc Policy. 2021 Mar 4;14:895-900. doi: 10.2147/RMHP.S299233. eCollection 2021.
In the background of the global pandemic, we aim to investigate the effect of COVID-19 on diagnosis and treatment delay in urology patients.
A total of 4919 inpatients were identified from the urological department in our institution, including 2947 and 1972 patients within 9 months before and after the outbreak (group A and group B). The baseline characteristics and residential population of different types of diseases were compared in the two groups. Patients who underwent delay of diagnosis or treatment with poor outcomes were described.
Our result revealed a 33.1% decrease of total resident population as well as a 44.8% decline in bed utilization rate after the outbreak. Significant differences were found between group A and group B in gender (P=0.024) and patients living alone or not (P=0.026). The hospitalization rate of patients with malignancy increased significantly while that of benign patients decreased during the epidemic (P<0.001). Besides, we identified 5 cases with bladder cancer and 3 cases with prostate cancer that underwent delay of diagnosis or treatment with unfavorable consequences.
With the impact of COVID-19, delay in diagnosis or treatment of non-COVID-19 diseases is inevitable whether the medical resources allocation is effective or not. Psychological status of patients might be the major cause of postponing diagnosis or treatment. For urological patients with locally advanced tumor or rapid progression, who need long-term postoperative intervention, the delay of regular treatment could lead to inevitable progression or recurrence.
在全球大流行的背景下，我们旨在研究新型冠状病毒肺炎（COVID-19）对泌尿外科患者诊断和治疗延迟的影响。
从我们机构的泌尿外科共确定了4919名住院患者，包括疫情爆发前9个月内的2947名患者和疫情爆发后9个月内的1972名患者（A组和B组）。比较两组不同类型疾病的基线特征和住院人数。描述了诊断或治疗延迟且预后不良的患者情况。
我们的结果显示，疫情爆发后住院总人数下降了33.1%，床位使用率下降了44.8%。A组和B组在性别（P=0.024）以及是否独居（P=0.026）方面存在显著差异。疫情期间恶性肿瘤患者的住院率显著增加，而良性疾病患者的住院率下降（P<0.001）。此外，我们确定了5例膀胱癌患者和3例前列腺癌患者，他们经历了诊断或治疗延迟并产生了不利后果。
受COVID-19影响，无论医疗资源分配是否有效，非COVID-19疾病的诊断或治疗延迟都不可避免。患者的心理状态可能是推迟诊断或治疗的主要原因。对于需要长期术后干预的局部晚期肿瘤或进展迅速的泌尿外科患者，常规治疗的延迟可能导致不可避免的进展或复发。
