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德国一家以角膜专科为主的三级眼科中心在 COVID-19 大流行期间急诊住院量的影响。

Impact of COVID-19 Pandemic on Emergency Inpatient Volume at a Tertiary Eye Care Center in Germany with Corneal Main Specialization.

机构信息

Department of Ophthalmology, Saarland University Medical Center, UKS, Homburg/Saar, Germany.

Dr. Rolf M. Schwiete Center for Limbal Stem Cell and Congenital Aniridia Research, Saarland University, Homburg/Saar, Germany.

出版信息

Klin Monbl Augenheilkd. 2021 Jun;238(6):715-720. doi: 10.1055/a-1327-3393. Epub 2021 Mar 17.

Abstract

BACKGROUND

To estimate the impact of the COVID-19 pandemic on emergency inpatient volume in a tertiary eye care center in Germany with corneal main subspecialization.

MATERIAL AND METHODS

A retrospective review of ocular emergency patients who attended the inpatient unit of the Department of Ophthalmology of Saarland University, Homburg/Saar, Germany during the COVID-19 pandemic, between 1 March and 30 April 2020, in comparison to the same time period in 2019. For each subject, clinical history and surgical reports were reviewed. After 24 March 2020, PCR examinations for SARS-CoV-2 were performed from throat swab specimens in all patients using real-time RT-PCR.

RESULTS

Totally, 135 patients were admitted in 2019 and 115 patients in 2020 as emergency cases. The patient age at the time of admission did not differ significantly between the two time periods (63.6 ± 17.9 years vs. 62.5 ± 19.6 years) (p = 0.792), but the average length of hospital stays increased significantly for 2020 (4.0 ± 3.6 vs. 4.4 ± 2.7 days, p = 0.043). The percentage of admissions due to acute corneal hydrops (0% vs. 3.5%) increased significantly from 2019 to 2020 (χ = 4.772, p = 0.028), however, there was not a significant difference between the two years for any other diagnosis (χ ≤ 3.564, p ≥ 0.059). From 2019 to 2020, the percentage of acute intravitreal anti-VEGF injections decreased significantly (7.9% vs. 1.3%, χ = 3.985, p = 0.045), but the proportion of other emergency surgeries did not differ between the two years (χ ≤ 3.617, p ≥ 0.057). COVID-19 PCR examination was performed in 66 (57.4%) cases in 2020 and all samples (100%) were negative.

CONCLUSIONS

The COVID pandemic did not change emergency inpatient volume in our department, but duration of hospital stay was extended on average by 8 hours, mainly due to additional COVID-19-PCR examinations. The proportion of the most frequently performed surgeries did not change remarkably between 2019 and 2020, but with the introduction of Muraine's sutures in 2019, the percentage of admissions with acute corneal hydrops (with or without subsequent surgery) increased for 2020. No urgent surgery had to be postponed due to the COVID-19 pandemic at our department; all operations were performed successfully.

摘要

背景

评估 COVID-19 大流行对德国一家拥有角膜专科的三级眼科中心急诊住院量的影响。

材料与方法

回顾性分析 2020 年 3 月 24 日至 4 月 30 日期间,德国萨尔兰州大学霍姆堡眼科系眼科住院部收治的 COVID-19 大流行期间的眼部急诊患者,与 2019 年同期相比。对每位患者的临床病史和手术报告进行了回顾。自 2020 年 3 月 24 日起,对所有患者的咽拭子标本均采用实时 RT-PCR 法进行 SARS-CoV-2 的 PCR 检测。

结果

2019 年共收治 135 例,2020 年收治 115 例。两个时期的入院时患者年龄无显著差异(63.6±17.9 岁比 62.5±19.6 岁)(p=0.792),但 2020 年的平均住院时间显著延长(4.0±3.6 天比 4.4±2.7 天,p=0.043)。2019 年至 2020 年因急性角膜水肿(0%比 3.5%)而入院的比例显著增加(χ=4.772,p=0.028),但其他任何诊断的两年间差异均无统计学意义(χ≤3.564,p≥0.059)。自 2019 年至 2020 年,急性玻璃体内抗 VEGF 注射的比例显著下降(7.9%比 1.3%,χ=3.985,p=0.045),但两年间其他急诊手术的比例无差异(χ≤3.617,p≥0.057)。2020 年共对 66 例(57.4%)患者进行了 COVID-19 PCR 检测,所有样本(100%)均为阴性。

结论

COVID-19 大流行并未改变我院的急诊住院量,但平均住院时间延长了 8 小时,主要是由于额外进行了 COVID-19-PCR 检测。2019 年至 2020 年期间,最常进行的手术比例无显著变化,但由于 2019 年引入了 Muraine 缝线,2020 年因急性角膜水肿(无论是否随后进行手术)而入院的比例增加。我院无紧急手术因 COVID-19 大流行而推迟;所有手术均成功完成。

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