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新冠疫情:对入住SARI重症监护病房的非新冠患者的收治、诊断及治疗的影响

COVID-19 Pandemic: Impact on Admission, Diagnosis, and Treatment of Non-COVID-19 Patients Admitted to SARI ICU.

作者信息

Arunachala Sumalatha, Venkatesh Bhumika T, Tusharbhai Bhatt Margiben, Puranik Amitha, Rao Shwethapriya, Ravindranath Sunil

机构信息

Department of Anaesthesia and Critical Care, JSS Medical College and Hospital, Mysuru, Karnataka, India.

Public Health Evidence South Asia, Prasanna School of Public Health, Manipal Academy of Higher Education, Manipal, Karnataka, India.

出版信息

Indian J Crit Care Med. 2021 Aug;25(8):853-859. doi: 10.5005/jp-journals-10071-23942.

Abstract

Coronavirus disease 2019 (COVID-19) pandemic has caused a huge burden on healthcare services worldwide, severely affecting the management of non-COVID-19 patients as well. The Government of India has updated guidelines for the clinical management of COVID-19 illness, including severe acute respiratory infections (SARI) definition for triaging suspected COVID-19 cases in an isolated intensive care unit (ICU). The aim of this study was to estimate the adherence of clinicians in triaging COVID-19 suspects as per SARI definition to SARI ICU. This study also observed the impact of such triaging on admission, diagnosis, and treatment process of non-COVID-19 patients admitted to SARI ICU. This cross-sectional study was conducted in a designated SARI ICU of two tertiary care medical college hospitals involving 78 patients from the month of June to July 2020. Data related to demographics, the severity of illness, advanced life supports, delay in diagnosis, intervention, and treatment of patients in SARI ICU due to suspected COVID-19 status were documented. Adherence to SARI definition for triaging COVID-19-suspect cases was 19.2%. Despite hindrance in diagnosis (17.9%) and treatment (12.8%), mortality among patients in SARI ICU was limited to 14.10%. Results were insignificant when checked for various factors associated with mortality. Nonadherence to SARI definition may lead to undue delay in diagnosis, intervention, and treatment of non-COVID-19 cases. This may result in increased morbidity, mortality, and economic burden on patients and the healthcare system. A rationale and just utilization of healthcare resources are need of the hour in the face of an enormous volume of SARI cases during COVID-19 pandemic. SARI criteria as implemented by the Ministry of Health and Family Welfare (MOHFW), Government of India, are a very important tool in triaging of COVID-19-suspect cases. Adequate measures should be in place in order to mitigate the inadequacies and deficiencies in the treatment of non-COVID-19 cases, which have occurred as a result of COVID-19 pandemic. Arunachala S, Venkatesh BT, Bhatt MT, Puranik A, Rao S, Ravindranath S. COVID-19 Pandemic: Impact on Admission, Diagnosis, and Treatment of Non-COVID-19 Patients Admitted to SARI ICU. Indian J Crit Care Med 2021;25(8):853-859.

摘要

2019年冠状病毒病(COVID-19)大流行给全球医疗服务带来了巨大负担,也严重影响了非COVID-19患者的管理。印度政府更新了COVID-19疾病的临床管理指南,包括在隔离重症监护病房(ICU)对疑似COVID-19病例进行分流的严重急性呼吸道感染(SARI)定义。本研究的目的是评估临床医生按照SARI定义将COVID-19疑似病例分流至SARI ICU的依从性。本研究还观察了这种分流对入住SARI ICU的非COVID-19患者的入院、诊断和治疗过程的影响。这项横断面研究在两家三级医疗学院医院的指定SARI ICU进行,纳入了2020年6月至7月的78例患者。记录了与人口统计学、疾病严重程度、高级生命支持、因疑似COVID-19状态导致的SARI ICU患者诊断、干预和治疗延迟相关的数据。按照SARI定义对COVID-19疑似病例进行分流的依从率为19.2%。尽管存在诊断(17.9%)和治疗(12.8%)方面的障碍,但SARI ICU患者的死亡率仅为14.10%。检查与死亡率相关的各种因素时,结果无统计学意义。不遵守SARI定义可能导致非COVID-19病例的诊断、干预和治疗出现不必要的延迟。这可能导致患者发病率、死亡率增加以及患者和医疗系统的经济负担加重。在COVID-19大流行期间面对大量SARI病例时,合理且公正地利用医疗资源是当务之急。印度卫生和家庭福利部(MOHFW)实施的SARI标准是对COVID-19疑似病例进行分流的非常重要的工具。应采取适当措施,以减轻因COVID-19大流行导致的非COVID-19病例治疗中的不足和缺陷。阿鲁纳恰拉·S、文卡特什·B·T、巴特·M·T、普拉尼克·A、拉奥·S、拉温德拉纳特·S。COVID-19大流行:对入住SARI ICU的非COVID-19患者入院、诊断和治疗的影响。《印度重症监护医学杂志》2021年;25(8):853 - 859。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4f4c/8559740/39d751495437/ijccm-25-853-g001.jpg

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