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COVID-19 对三级大学医院第一波和第二波期间择期、急诊和肿瘤手术的影响:我们吸取教训了吗?

Impact of COVID-19 on elective, emergency and oncological surgery during the first and the second wave in a tertiary university hospital : Have we learned the lessons?

机构信息

Department of Anaesthesiology and Intensive Care Medicine, Medical University of Innsbruck, Innsbruck, Austria.

Division of Intensive Care and Emergency Medicine, Department of Internal Medicine, Medical University of Innsbruck, Innsbruck, Austria.

出版信息

Wien Klin Wochenschr. 2022 Dec;134(23-24):868-874. doi: 10.1007/s00508-022-02041-y. Epub 2022 May 24.

DOI:10.1007/s00508-022-02041-y
PMID:35608675
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9127820/
Abstract

BACKGROUND

The COVID-19 pandemic caused an important reduction in surgical activities during the first wave. Aim of this retrospective time-trend analysis was to examine whether also during the second wave in fall and winter 2020/2021 surgical interventions decreased.

METHODS

Absolut numbers and types of surgeries in a tertiary university hospital during the second COVID-19 wave in fall/winter 2020/2021 were collected from the surgical planning software and compared with the same time frame over the last 5 years. In a second step, the reduction of surgical interventions during the second wave was compared with the reduction of surgical procedures during the first wave in spring 2020 at the same hospital.

RESULTS

Despite a higher 7‑day incidence of COVID-19 infection and a higher number of patients needing ICU treatment during the second wave, the reduction of surgical interventions was 3.22% compared to 65.29% during the first wave (p < 0.0001). Elective surgical interventions decreased by 88.63% during the first wave compared to 1.79% during the second wave (p < 0.0001). Emergency and oncological interventions decreased by 35.17% during the first wave compared to 5.15% during the second wave (p : 0.0007) and 47.59% compared to 3.89% (p < 0.0001), respectively. Surgical activity reduction in our institution was less pronounced despite higher occupancy of ICU beds during the second COVID-19 wave in fall/winter 2020/2021.

CONCLUSION

Better understanding of the disease, adequate supply of disposables and improved interdisciplinary day by day management of surgical and ICU resources may have contributed to this improvement.

摘要

背景

COVID-19 大流行导致第一波疫情期间手术活动大幅减少。本回顾性时间趋势分析旨在研究 2020 年秋季至冬季的第二波疫情期间,手术干预是否也减少。

方法

从手术计划软件中收集了一家三级大学医院在 2020 年秋季至冬季第二波 COVID-19 期间的绝对手术数量和类型,并与过去 5 年同期进行了比较。在第二步中,将第二波疫情期间手术干预的减少与同一医院 2020 年春季第一波疫情期间手术程序的减少进行了比较。

结果

尽管第二波疫情期间 COVID-19 感染的 7 天发病率较高,需要 ICU 治疗的患者人数较多,但与第一波疫情期间相比,手术干预的减少幅度为 3.22%(p<0.0001)。第一波疫情期间,择期手术干预减少了 88.63%,而第二波疫情期间仅减少了 1.79%(p<0.0001)。第一波疫情期间,紧急和肿瘤手术干预分别减少了 35.17%和 47.59%,而第二波疫情期间分别减少了 5.15%和 3.89%(p<0.0001)。尽管我们机构在第二波 COVID-19 疫情(2020 年秋季至冬季)期间 ICU 床位占用率较高,但手术活动的减少程度并不明显。

结论

更好地了解疾病、充足的一次性用品供应以及每天不断改进的手术和 ICU 资源的跨学科管理,可能促成了这一改善。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/986e/9747869/39908b570142/508_2022_2041_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/986e/9747869/38cbfbfb2f85/508_2022_2041_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/986e/9747869/39908b570142/508_2022_2041_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/986e/9747869/38cbfbfb2f85/508_2022_2041_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/986e/9747869/39908b570142/508_2022_2041_Fig2_HTML.jpg

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