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纽约市在新冠疫情期间禁止非紧急手术对妇科肿瘤患者护理的影响。

The impact of the ban on elective surgery in New York City during the coronavirus outbreak on gynecologic oncology patient care.

作者信息

Lee Sarah S, Ceasar Danial, Margolis Benjamin, Venkatesh Pooja, Espino Kevin, Gerber Deanna, Boyd Leslie R

机构信息

New York University Langone Health, Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, New York, NY, United States.

New York University Langone Health, Department of Obstetrics and Gynecology, United States.

出版信息

Gynecol Oncol Rep. 2022 Jun;41:100997. doi: 10.1016/j.gore.2022.100997. Epub 2022 May 10.

Abstract

INTRODUCTION

Elective surgical procedures were suspended during the coronavirus disease pandemic (COVID-19) in New York City (NYC) between March 16 and June 15, 2020. This study characterizes the impact of the ban on surgical delays for patients scheduled for surgery during this first wave of the COVID-19 outbreak.

METHODS

Patients who were scheduled for surgical treatment of malignant or pre-invasive disease by gynecologic oncologists at three NYC hospitals during NYC's ban on elective surgery were included. Outcomes of interest were the percentage of patients experiencing surgical delay and the nature of delays. Kruskal-Wallis, chi-square, and logistic regression tests were performed with significance set at p < 0.05.

RESULTS

Of the 145 patients with malignant or pre-invasive diseases scheduled for surgery during the ban on elective surgery, 40% of patients experienced one or more surgical delays, 10% experienced two or more and 1% experienced three surgical delays. Of patients experiencing an initial delay, 77% were hospital-initiated and 11% were due to known or suspected personal COVID-19. Overall, 81% of patients completed their planned treatment, and 93% of patients underwent their initially planned surgery. Among patients for whom adjuvant therapy was recommended, 67% completed their planned treatment, and the most common reasons for not completing treatment were medically indicated followed by concerns regarding COVID-19.

CONCLUSION

During the ban on elective surgery in NYC during the first outbreak of the COVID-19 pandemic, many patients experienced minor surgical delays, but most patients obtained appropriate, timely care with either surgery or alternative treatment.

摘要

引言

2020年3月16日至6月15日期间,纽约市(NYC)因冠状病毒病大流行(COVID-19)暂停了择期外科手术。本研究描述了在COVID-19疫情第一波期间,该禁令对计划接受手术患者手术延迟的影响。

方法

纳入在纽约市禁止择期手术期间,纽约市三家医院的妇科肿瘤学家计划对恶性或癌前疾病进行手术治疗的患者。感兴趣的结果是经历手术延迟的患者百分比和延迟的性质。进行了Kruskal-Wallis检验、卡方检验和逻辑回归检验,显著性设定为p < 0.05。

结果

在禁止择期手术期间计划接受手术的145例恶性或癌前疾病患者中,40%的患者经历了一次或多次手术延迟,10%的患者经历了两次或更多次延迟,1%的患者经历了三次手术延迟。在经历首次延迟的患者中,77%是医院发起的,11%是由于已知或疑似个人感染COVID-19。总体而言,81%的患者完成了计划的治疗,93%的患者接受了最初计划的手术。在被建议进行辅助治疗的患者中,67%完成了计划的治疗,未完成治疗的最常见原因是医学指征,其次是对COVID-19的担忧。

结论

在COVID-19大流行首次爆发期间纽约市禁止择期手术期间,许多患者经历了轻微的手术延迟,但大多数患者通过手术或替代治疗获得了适当、及时的护理。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2d98/9142542/c8ada4e2c0e7/gr1.jpg

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