Campos Letícia Nunes, Bryce-Alberti Mayte, Gerk Ayla, Hill Sarah K, Calderon Chrystal, Zaigham Mehreen, Del Valle Diana D, Mita Carol, Juran Sabrina, Ferreira Júlia Loyola, Uribe-Leitz Tarsicio
Program in Global Surgery and Social Change, Harvard Medical School, Boston, MA, USA.
Faculty of Medical Sciences, Universidade de Pernambuco, Recife, PE, Brazil.
Lancet Reg Health Am. 2024 Oct 16;40:100908. doi: 10.1016/j.lana.2024.100908. eCollection 2024 Dec.
This scoping review assessed the surgical backlog in Latin America and the Caribbean (LAC) due to COVID-19 and identified mitigation strategies. We searched seven databases for citations from December 2019 to December 2022, focusing on LAC patients with cancelled or postponed procedures. We registered our protocol at Open Science Framework (https://osf.io/x2nd8) and adhered to PRISMA-ScR guidelines. We included 83 citations covering 23 LAC countries and 19 surgical specialities, with Brazil (67%, 56/83) and transplant surgery (24%, 20/83) being the most documented. Surgical backlogs were mainly reported at the hospital (44%, 37/83) and national levels (38%, 32/83). We identified 58 citations that reported a total of 42 strategies to mitigate the backlog, the most cited being establishing prioritisation criteria for surgical cases (41%, 24/58). Our findings highlight challenges across differing healthcare systems in LAC, including disparities in data availability, surgical capacity, and resource allocation. For instance, while countries like Brazil had extensive data on national surgical backlogs, others lacked comprehensive national-level data. Our review can help inform policymakers and healthcare stakeholders to implement targeted interventions to prepare LAC-based surgical systems for future health emergencies.
本综述评估了拉丁美洲和加勒比地区（LAC）因新冠疫情导致的手术积压情况，并确定了缓解策略。我们检索了七个数据库，以获取2019年12月至2022年12月期间的文献引用，重点关注手术被取消或推迟的LAC患者。我们在开放科学框架（https://osf.io/x2nd8）上注册了我们的方案，并遵循PRISMA-ScR指南。我们纳入了83篇文献引用，涵盖23个LAC国家和19个外科专科，其中巴西的文献引用最多（67%，56/83），移植手术的文献引用占比24%（20/83）。手术积压主要在医院层面（44%，37/83）和国家层面（38%，32/83）被报道。我们确定了58篇文献引用，它们共报告了42项缓解积压的策略，其中被引用最多的是为手术病例制定优先排序标准（41%，24/58）。我们的研究结果突出了LAC不同医疗系统面临的挑战，包括数据可用性、手术能力和资源分配方面的差异。例如，虽然像巴西这样的国家有关于全国手术积压的广泛数据，但其他国家缺乏全面的国家层面数据。我们的综述有助于为政策制定者和医疗利益相关者提供信息，以便实施有针对性的干预措施，使基于LAC的手术系统为未来的健康紧急情况做好准备。
