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COVID-19大流行对法赫德国王大学医院小儿外科收治模式及病例后续就诊质量的影响:一项对比研究及单中心经验

Effect of COVID-19 Pandemic on Admission Pattern to Pediatric Surgery Division at King Fahad University Hospital and Subsequent Quality of Presentation in Cases: A Comparative Study and Single-Center Experience.

作者信息

Alsunnary Njoud J, Al Turkistani Lujain, Alhemaid Shareefa, Al Shehab Fatimah, Al Hashimi Maryam, Elshafei Hossam, Al-Buainain Hussah M, Alkhudaimi Rawan A, Alshaikh Husain N

机构信息

Medical School, Imam Abdulrahman Bin Faisal University, Dammam, SAU.

Surgery, King Fahad University Hospital, Dammam, SAU.

出版信息

Cureus. 2024 Aug 6;16(8):e66305. doi: 10.7759/cureus.66305. eCollection 2024 Aug.

Abstract

The coronavirus disease 2019 (COVID-19) pandemic has affected healthcare systems worldwide, with mandatory quarantine and isolation measures being implemented to curb the spread of the virus. These measures have potentially led to delayed or complicated presentations of non-COVID-19 cases, including pediatric surgical cases. This study aims to evaluate pediatric surgical admission patterns, analyze the incidence of surgical diagnoses, and assess the severity of presentation during the COVID-19 period compared to the pre-COVID-19 period. This retrospective observational study was conducted at a university hospital in the eastern region of Saudi Arabia to assess the effect of the pandemic on pediatric surgery admissions patterns and severity of presentation during the COVID-19 period (March 2, 2020, to March 1, 2022) and pre-COVID-19 period (March 1, 2018, to March 1, 2020). Of the 903 pediatric surgical admissions, 366 (40.5%) presented during the COVID-19 period. The admission rate per month decreased by 6.9 during COVID-19 compared to pre-COVID-19 (mean [SD]: 21.5 [9.3] vs. 14.6 [8.2], p = 0.01). The most common admission diagnoses were appendicitis (17.5%) and inguinal hernia (15.8%). There was a 15% increase in the percentage of emergency admissions (54.4% vs. 47.3%, p = 0.037) during COVID-19 compared to pre-COVID-19. Of note, the percentage of patients admitted with acute appendicitis increased by 35.9% (20.8% vs. 15.3%, p = 0.03). Furthermore, the emergency admissions for patients with inguinal hernia doubled (26.6% vs. 12.7%, p = 0.035). No significant difference in ICU admissions, hospital length of stay, and routine discharge were observed. In conclusion, the COVID-19 pandemic correlated with a significant decrease in overall admissions and an increase in emergency admissions, including those for appendicitis and inguinal hernia. The increase in complicated conditions was not significant. There was no significant difference in ICU admissions and hospital length of stay. Future studies involving multiple centers are necessary to validate these findings.

摘要

2019年冠状病毒病(COVID-19)大流行影响了全球医疗系统,为遏制病毒传播实施了强制隔离措施。这些措施可能导致非COVID-19病例(包括小儿外科病例)的就诊延迟或情况复杂化。本研究旨在评估小儿外科入院模式,分析手术诊断的发生率,并评估COVID-19期间与COVID-19之前相比的就诊严重程度。这项回顾性观察研究在沙特阿拉伯东部地区的一家大学医院进行,以评估大流行对COVID-19期间(2020年3月2日至2022年3月1日)和COVID-19之前(2018年3月1日至2020年3月1日)小儿外科入院模式和就诊严重程度的影响。在903例小儿外科入院病例中,366例(40.5%)在COVID-19期间就诊。与COVID-19之前相比,COVID-19期间每月入院率下降了6.9(平均值[标准差]:21.5[9.3]对14.6[8.2],p=0.01)。最常见的入院诊断是阑尾炎(17.5%)和腹股沟疝(15.8%)。与COVID-19之前相比,COVID-19期间急诊入院百分比增加了15%(54.4%对47.3%,p=0.037)。值得注意的是,急性阑尾炎入院患者百分比增加了35.9%(20.8%对15.3%,p=0.03)。此外,腹股沟疝患者的急诊入院率翻了一番(26.6%对12.7%,p=0.035)。在重症监护病房入院、住院时间和常规出院方面未观察到显著差异。总之,COVID-19大流行与总体入院人数显著减少以及急诊入院人数增加相关,包括阑尾炎和腹股沟疝患者。复杂病情的增加并不显著。重症监护病房入院和住院时间没有显著差异。未来需要多中心研究来验证这些发现。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3546/11382740/af405c30adff/cureus-0016-00000066305-i01.jpg

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