Department of Radiation Oncology, University Hospital Halle (Saale), Ernst-Grube-Straße 40, 06120, Halle (Saale), Germany.
Department of Radiation Oncology, University Medical Center Magdeburg, Magdeburg, Germany.
Strahlenther Onkol. 2022 Apr;198(4):334-345. doi: 10.1007/s00066-021-01883-1. Epub 2022 Jan 7.
To assess the change in inpatient radiotherapy related to COVID-19 lockdown measures during the first wave of the pandemic in 2020.
We included cases hospitalized between January 1 and August 31, 2018-2020, with a primary ICD-10 diagnosis of C00-C13, C32 (head and neck cancer, HNC) and C53 (cervical cancer, CC). Data collection was conducted within the Medical Informatics Initiative. Outcomes were fractions and admissions. Controlling for decreasing hospital admissions during holidays, calendar weeks of 2018/2019 were aligned to Easter 2020. A lockdown period (LP; 16/03/2020-02/08/2020) and a return-to-normal period (RNP; 04/05/2020-02/08/2020) were defined. The study sample comprised a control (admission 2018/19) and study cohort (admission 2020). We computed weekly incidence and IR ratios from generalized linear mixed models.
We included 9365 (CC: 2040, HNC: 7325) inpatient hospital admissions from 14 German university hospitals. For CC, fractions decreased by 19.97% in 2020 compared to 2018/19 in the LP. In the RNP the reduction was 28.57% (p < 0.001 for both periods). LP fractions for HNC increased by 10.38% (RNP: 9.27%; p < 0.001 for both periods). Admissions for CC decreased in both periods (LP: 10.2%, RNP: 22.14%), whereas for HNC, admissions increased (LP: 2.25%, RNP: 1.96%) in 2020. Within LP, for CC, radiotherapy admissions without brachytherapy were reduced by 23.92%, whereas surgery-related admissions increased by 20.48%. For HNC, admissions with radiotherapy increased by 13.84%, while surgery-related admissions decreased by 11.28% in the same period.
Related to the COVID-19 lockdown in an inpatient setting, radiotherapy for HNC treatment became a more frequently applied modality, while admissions of CC cases decreased.
评估 2020 年大流行第一波期间与 COVID-19 封锁措施相关的住院放疗变化。
我们纳入了 2018 年至 2020 年 1 月 1 日至 8 月 31 日期间住院的患者，其主要 ICD-10 诊断为 C00-C13、C32（头颈部癌，HNC）和 C53（宫颈癌，CC）。数据收集在医学信息学倡议内进行。结果为分数和入院次数。在控制假期住院人数减少的情况下，2018/2019 年的日历周与 2020 年复活节对齐。定义了封锁期（LP；2020 年 3 月 16 日至 2 月 8 日）和恢复正常期（RNP；2020 年 4 月 4 日至 2 月 8 日）。研究样本包括对照组（2018/19 年入院）和研究队列（2020 年入院）。我们使用广义线性混合模型计算每周发病率和发病率比。
我们纳入了来自 14 家德国大学医院的 9365 例（CC：2040 例，HNC：7325 例）住院医院入院患者。对于 CC，与 2018/19 年相比，2020 年 LP 期间分数下降了 19.97%。在 RNP 中，降幅为 28.57%（两个时期均为 p<0.001）。HNC 的 LP 分数增加了 10.38%（RNP：9.27%；两个时期均为 p<0.001）。CC 的入院人数在两个时期都减少了（LP：10.2%，RNP：22.14%），而 HNC 的入院人数增加了（LP：2.25%，RNP：1.96%）。在 LP 内，对于 CC，没有近距离放疗的放疗入院减少了 23.92%，而与手术相关的入院增加了 20.48%。对于 HNC，接受放疗的入院人数增加了 13.84%，而在同一时期与手术相关的入院人数减少了 11.28%。
与住院环境中的 COVID-19 封锁相关，HNC 治疗的放疗成为更常应用的治疗方式，而 CC 病例的入院人数减少。
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