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一项关于新冠病毒病对普通外科急诊影响的回顾性研究。

A Retrospective Study on the Impact of COVID-19 on Emergency General Surgery.

作者信息

Kretzmer Leo, Elmaradny Ahmed, Jabir Murad A, Hussain Rahim, Bhambra Maninder, Mourad Moustafa, Robinson Steven J, Wadley Martin, Perry Anthony, Saad Mohamed

机构信息

Department of General Surgery, Worcestershire Acute Hospitals NHS Trust, Worcester, GBR.

Department of General and UGI (Upper Gastrointestinal) Surgery, Worcestershire Acute Hospitals NHS Trust, Worcester, GBR.

出版信息

Cureus. 2022 Sep 18;14(9):e29281. doi: 10.7759/cureus.29281. eCollection 2022 Sep.

Abstract

Background The coronavirus pandemic has caused global disruption to all aspects of life. This disturbance has been most notable in the medical world. Political, societal, medical, and behavioral alterations have forced emergency surgical practices to adapt. This study investigated the impact of coronavirus 2019 (COVID-19) at a busy surgical center. Methodology This is a retrospective observational study. Three study periods were analyzed: pre-COVID, first wave, and second wave. Data were collected on referrals, diagnoses, investigations, management pathways, outcomes, patient behavior, and consultant practice. A one-way analysis of variance (ANOVA test) was used for the analysis of parametric data and the Mann-Whitney U test for non-parametric data. Results Declining numbers of patients presented across the three periods. There was a severe disruption in performing emergency general surgeries during the first wave, propagated by alterations in clinical decision-making, as well as fluctuations in societal and patient behavior. Despite the effects of the second wave being significantly more profound in terms of hospitalization and COVID-related mortality, a paradoxical, gradual return to the norm was noted, which was seen in referral pathways, imaging decisions, and management strategies. Conclusion Our data is suggestive of society, both within and outside the medical sphere, adjusting to life with COVID-19.

摘要

背景 冠状病毒大流行已对生活的各个方面造成全球干扰。这种干扰在医学界最为显著。政治、社会、医学和行为方面的改变迫使急诊外科实践做出调整。本研究调查了2019冠状病毒病(COVID-19)在一个繁忙外科中心的影响。

方法 这是一项回顾性观察研究。分析了三个研究时期:COVID-19之前、第一波疫情和第二波疫情。收集了关于转诊、诊断、检查、管理途径、结果、患者行为和会诊医生实践的数据。采用单因素方差分析(ANOVA检验)分析参数数据,采用曼-惠特尼U检验分析非参数数据。

结果 在这三个时期就诊的患者数量不断减少。在第一波疫情期间,急诊普通外科手术受到严重干扰,这是由临床决策的改变以及社会和患者行为的波动造成的。尽管第二波疫情在住院率和COVID-19相关死亡率方面的影响更为深远,但出现了一种矛盾的、逐渐恢复正常的情况,这在转诊途径、影像学决策和管理策略中都有体现。

结论 我们的数据表明,医疗领域内外的社会都在适应与COVID-19共存的生活。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c88a/9578094/b212f9b2c8d0/cureus-0014-00000029281-i01.jpg

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