2019年冠状病毒病大流行对急性护理手术患者的结局、发病率和死亡率的影响：一项回顾性队列研究。
Impact of the COVID-19 pandemic on the outcome, morbidity, and mortality of acute care surgery patients: A retrospective cohort study.
作者信息
Krutsri Chonlada, Singhatas Pongsasit, Sumpritpradit Preeda, Thampongsa Tharin, Phuwapraisirisan Samart, Gesprasert Goragoch, Jirasiritham Jakrapan
机构信息
Division of Trauma Surgery and Surgical Critical Care, Department of Surgery, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
Surgical Research Unit, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
出版信息
Int J Surg Open. 2021 Jan;28:50-55. doi: 10.1016/j.ijso.2020.11.021. Epub 2020 Dec 3.
BACKGROUND
Coronavirus disease (COVID-19) has impacted both emergency and elective surgical management owing to its highly infectious nature and the shortage of personal protective equipment. This study aimed to review the outcomes of emergency surgical conditions and trauma during the pandemic lockdown.
MATERIAL AND METHODS
We retrospectively reviewed and collected data from patients who attended the Acute Care Surgery Service from 1st April to May 31st, 2020 during Thailand's COVID-19 pandemic lockdown. We separated staff and performed preoperative COVID-19 swab testing on all patients to assess the requirement for personal protective equipment. Compared with previous years of service, of 2018 and 2019. Preoperative COVID-19 testing was performed using multiplex and manual RT-PCR. Morbidity and mortality, consultation time, and waiting time to surgery were analyzed.
RESULTS
A total of 61 patients were enrolled. The average age of patients was 53.8 years. The average consultation time, waiting time to surgery, and surgical duration were 10 min, 660 min, and 88.77 min, respectively. The average time taken to obtain the preoperative COVID-19 test result was 227.26 min. The morbidity and mortality rates were 9.84% and 1.64%, respectively. Compared with the same period in 2018 and 2019, consultation time was significantly faster (10 min; p = 0.033) and waiting time to surgery was significantly longer (660 min, respectively; p = 0.011). Morbidity and mortality between pandemic period and the previous year of service were not significantly different. No medical workers were infected with COVID-19.
CONCLUSIONS
During the COVID-19 pandemic, optimal triage of emergency patients is key. Waiting for preoperative COVID-19 swab testing in emergency case is safe and results in good outcomes. Although the waiting time to surgery was significantly longer owing to the time required to receive preoperative COVID-19 swab results, morbidity and mortality rates were unaffected.
背景
冠状病毒病（COVID-19）因其高度传染性和个人防护设备短缺，对急诊和择期手术管理均产生了影响。本研究旨在回顾疫情封锁期间急诊手术情况和创伤的治疗结果。
材料与方法
我们回顾性分析并收集了2020年4月1日至5月31日泰国COVID-19疫情封锁期间在急性护理外科就诊的患者数据。我们对工作人员进行了区分，并对所有患者进行术前COVID-19拭子检测，以评估个人防护设备的需求。与2018年和2019年的前几年服务情况进行比较。术前COVID-19检测采用多重和手动逆转录聚合酶链反应（RT-PCR）。分析了发病率、死亡率、会诊时间和手术等待时间。
结果
共纳入61例患者。患者的平均年龄为53.8岁。平均会诊时间、手术等待时间和手术时长分别为10分钟、660分钟和88.77分钟。获得术前COVID-19检测结果的平均时间为227.26分钟。发病率和死亡率分别为9.84%和1.64%。与2018年和2019年同期相比，会诊时间明显更快（10分钟；p = 0.033），手术等待时间明显更长（分别为660分钟；p = 0.011）。疫情期间与上一年服务期间的发病率和死亡率无显著差异。没有医护人员感染COVID-19。
结论
在COVID-19大流行期间，对急诊患者进行最佳分诊是关键。在急诊病例中等待术前COVID-19拭子检测是安全的，且结果良好。尽管由于获取术前COVID-19拭子结果所需时间，手术等待时间明显更长，但发病率和死亡率并未受到影响。
Zotero 插件