Stroman Luke, Russell Beth, Kotecha Pinky, Kantartzi Anastasia, Ribeiro Luis, Jackson Bethany, Ismaylov Vugar, Debo-Aina Adeoye Oluwakanyinsola, MacAskill Findlay, Kum Francesca, Kulkarni Meghana, Sandher Raveen, Walsh Anna, Doerge Ella, Guest Katherine, Kailash Yamini, Simson Nick, McDonald Cassandra, Mensah Elsie, June Tay Li, Chalokia Ramandeep, Clovis Sharon, Eversden Elizabeth, Cossins Jane, Rusere Jonah, Zisengwe Grace, Fleure Louisa, Cooper Leslie, Chatterton Kathryn, Barber Amelia, Roberts Catherine, Azavedo Thomasia, Ritualo Jeffrey, Omana Harold, Mills Liza, Studd Lily, El Hage Oussama, Nair Rajesh, Malde Sachin, Sahai Arun, Fernando Archana, Taylor Claire, Challacombe Benjamin, Thurairaja Ramesh, Popert Rick, Olsburgh Jonathon, Cathcart Paul, Brown Christian, Hadjipavlou Marios, Di Benedetto Ella, Bultitude Matthew, Glass Jonathon, Yap Tet, Zakri Rhana, Shabbir Majed, Willis Susan, Thomas Kay, O'Brien Tim, Khan Muhammad Shamim, Dasgupta Prokar
Department of Urology Guy's Hospital Guys' & St Thomas' NHS Foundation Trust London UK.
Department of Translational Oncology and Urology Research King's College London London UK.
BJUI Compass. 2021 Mar;2(2):97-104. doi: 10.1002/bco2.56. Epub 2021 Jan 21.
To determine the safety of urological admissions and procedures during the height of the COVID-19 pandemic using "hot" and "cold" sites. The secondary objective is to determine risk factors of contracting COVID-19 within our cohort.
A retrospective cohort study of all consecutive patients admitted from March 1 to May 31, 2020 at a high-volume tertiary urology department in London, United Kingdom. Elective surgery was carried out at a "cold" site requiring a negative COVID-19 swab 72-hours prior to admission and patients were required to self-isolate for 14-days preoperatively, while all acute admissions were admitted to the "hot" site.Complications related to COVID-19 were presented as percentages. Risk factors for developing COVID-19 infection were determined using multivariate logistic regression analysis.
A total of 611 patients, 451 (73.8%) male and 160 (26.2%) female, with a median age of 57 (interquartile range 44-70) were admitted under the urology team; 101 (16.5%) on the "cold" site and 510 (83.5%) on the "hot" site. Procedures were performed in 495 patients of which eight (1.6%) contracted COVID-19 postoperatively with one (0.2%) postoperative mortality due to COVID-19. Overall, COVID-19 was detected in 20 (3.3%) patients with two (0.3%) deaths. Length of stay was associated with contracting COVID-19 in our cohort (OR 1.25, 95% CI 1.13-1.39).
Continuation of urological procedures using "hot" and "cold" sites throughout the COVID-19 pandemic was safe practice, although the risk of COVID-19 remained and is underlined by a postoperative mortality.
利用“热区”和“冷区”确定在新冠疫情高峰期泌尿外科住院治疗及手术操作的安全性。次要目的是确定我们队列中感染新冠病毒的风险因素。
对2020年3月1日至5月31日期间，英国伦敦一家大型三级泌尿外科连续收治的所有患者进行回顾性队列研究。择期手术在“冷区”进行，要求患者入院前72小时新冠病毒检测呈阴性，且术前需自我隔离14天，而所有急症患者则收治于“热区”。与新冠病毒相关的并发症以百分比形式呈现。采用多因素逻辑回归分析确定感染新冠病毒的风险因素。
泌尿外科团队共收治611例患者，其中男性451例（73.8%），女性160例（26.2%），中位年龄57岁（四分位间距44 - 70岁）；101例（16.5%）在“冷区”，510例（83.5%）在“热区”。495例患者接受了手术，其中8例（1.6%）术后感染新冠病毒，1例（0.2%）因新冠病毒术后死亡。总体而言，20例（3.3%）患者检测出新冠病毒，2例（0.3%）死亡。在我们的队列中，住院时间与感染新冠病毒有关（比值比1.25，95%置信区间1.13 - 1.39）。
在整个新冠疫情期间，利用“热区”和“冷区”持续开展泌尿外科手术操作是安全的做法，尽管新冠病毒感染风险依然存在，且术后有死亡病例凸显了这一风险。
