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COVID-19 大流行对德国大学附属医院治疗性介入肿瘤学程序和诊断 CT/MRI 检查的影响。

Impact of the COVID-19 pandemic on therapeutic interventional oncology procedures and diagnostic CT/MRI examinations at a German university hospital.

机构信息

Institute and Polyclinic for Diagnostic und Interventional Radiology, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany.

出版信息

Rofo. 2023 Aug;195(8):707-712. doi: 10.1055/a-2081-4012. Epub 2023 May 24.

Abstract

PURPOSE

The COVID-19 pandemic led to the implementation of severe restrictions on public life in Germany and a reduction in the number of non-COVID patients presenting for care. The aim of this study was to measure the impact on the number of therapeutic interventional oncology procedures in relation to diagnostic imaging studies at a high-volume radiology department.

MATERIALS AND METHODS

The numbers of therapeutic interventional oncology procedures and diagnostic CT/MRI examinations for the years 2010 to 2021 were extracted using the hospital information system. Monthly data from January 2010 to December 2019 were used to build forecasting models for the timeframe from January 2020 to December 2021. Real procedure numbers were compared with predicted numbers to calculate residual differences, which were considered statistically significant if the real number was outside the 95 % confidence interval (p < 0.05).

RESULTS

During the first German lockdown (March/April 2020), the number of outpatient CT/MRI examinations decreased significantly, with a less pronounced decrease of overall CT/MRI numbers. The second German lockdown (January-May 2021) led to lower than predicted outpatient CT numbers, whereas outpatient MRI numbers in part even exceeded predicted numbers and overall CT/MRI numbers stayed within confidence limits. The lockdowns had a more pronounced negative effect on the number of oncological MRI examinations compared to CT examinations. The number of therapeutic interventional oncology procedures showed no significant decrease during both lockdowns.

CONCLUSION

Lockdown measures had minor impact on the number of therapeutic interventional oncology procedures, possibly due to a shift from more resource-intensive therapies like surgery towards interventional oncology. The overall numbers of diagnostic imaging decreased during the first lockdown, while the second lockdown had less negative impact. The number of oncological MRI examinations was affected most severely. To avoid adverse outcomes, specific protocols for patient management during future pandemic outbreaks should be implemented and continuously adapted.

KEY POINTS

· COVID-19 lockdowns had minor effect on therapeutic interventional oncology procedures.. · Numbers of diagnostic outpatient imaging procedures dropped markedly, especially during the first lockdown.. · The number of oncological MRI examinations showed a significant decrease during both lockdowns..

CITATION FORMAT

· Nebelung H, Radosa CG, Schön F et al. Impact of the COVID-19 pandemic on therapeutic interventional oncology procedures and diagnostic CT/MRI examinations at a German university hospital. Fortschr Röntgenstr 2023; 195: 707 - 712.

摘要

目的

COVID-19 大流行导致德国实施了严格的公共生活限制措施,并减少了非 COVID 患者就诊的数量。本研究旨在测量与大容量放射科的诊断成像研究相关的治疗性介入肿瘤学程序数量的变化。

材料和方法

使用医院信息系统提取 2010 年至 2021 年的治疗性介入肿瘤学程序和诊断 CT/MRI 检查的数量。使用 2010 年 1 月至 2019 年 12 月的每月数据,为 2020 年 1 月至 2021 年 12 月的时间段构建预测模型。将实际程序数量与预测数量进行比较,以计算残差,如果实际数量超出 95%置信区间(p<0.05),则认为残差具有统计学意义。

结果

在德国第一次封锁期间(2020 年 3 月/4 月),门诊 CT/MRI 检查数量显著减少,而整体 CT/MRI 数量的减少幅度较小。德国第二次封锁(2021 年 1 月至 5 月)导致门诊 CT 数量低于预测值,而门诊 MRI 数量在部分情况下甚至超过了预测值,整体 CT/MRI 数量仍在置信区间内。封锁措施对肿瘤学 MRI 检查的数量比对 CT 检查的数量有更明显的负面影响。两次封锁期间,治疗性介入肿瘤学程序的数量均无明显下降。

结论

封锁措施对治疗性介入肿瘤学程序的数量影响较小,这可能是由于手术等资源密集型治疗方法向介入肿瘤学的转变。第一次封锁期间,整体诊断成像数量下降,而第二次封锁的负面影响较小。肿瘤学 MRI 检查的数量受到的影响最为严重。为避免不良后果,应在未来的大流行爆发期间实施并不断调整特定的患者管理协议。

要点

· COVID-19 封锁对治疗性介入肿瘤学程序的影响较小。· 门诊诊断成像程序的数量明显下降,尤其是在第一次封锁期间。· 两次封锁期间,肿瘤学 MRI 检查的数量均显著减少。

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