University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada
Department Community Health Sciences, University of Calgary, Cumming School of Medicine, Calgary, Alberta, Canada.
BMJ Open. 2024 Aug 31;14(8):e085247. doi: 10.1136/bmjopen-2024-085247.
To ensure sufficient resources to care for patients with COVID-19, healthcare systems delayed non-urgent surgeries to free capacity. This study explores the consequences of delaying non-urgent surgery on surgical care and healthcare resource use.
This is a population-based retrospective cohort study.
This study took place in Alberta, Canada, from December 2018 to December 2021.
Adult patients scheduled for surgery in Alberta during the study period were included.
The proportion of surgeries completed and surgery wait time were the primary outcomes. The secondary outcomes were healthcare resource use (hospital length of stay, emergency room visits and physician visits). The association between the primary outcomes and patient and surgery-related variables was explored using regression.
There were 202 470 unique patients with 259 677 scheduled surgeries included. Fewer surgeries were completed throughout the pandemic compared with before; in the fourth wave, there was a decrease from 79% pre-COVID-19 to 67%. There was a decrease in wait time for those who had surgery completed during COVID-19 (from 105 to 69 days). Having surgery completed and the wait for surgery were associated with the geographical zone, COVID-19 wave, and the surgery type and priority. There was a decrease in all measures of healthcare resource use and an increase in hospital and all-cause mortality during COVID-19 compared with before COVID-19.
The change in the proportion of scheduled surgeries completed and the wait time for completed surgery was modest and associated with COVID-19 wave and surgery-related variables, which was aligned with policies enacted during COVID-19 for surgery. The decrease in healthcare resource use suggests the effects of the COVID-19 pandemic may be delayed and may result in many patients presenting with advanced disease requiring surgical care.
为确保有足够的资源来照顾 COVID-19 患者，医疗系统将非紧急手术推迟以腾出床位。本研究旨在探讨推迟非紧急手术对手术护理和医疗资源使用的影响。
这是一项基于人群的回顾性队列研究。
本研究于 2018 年 12 月至 2021 年 12 月在加拿大艾伯塔省进行。
纳入研究期间在艾伯塔省接受手术的成年患者。
完成手术的比例和手术等待时间是主要结果。次要结果为医疗资源使用（住院时间、急诊就诊和医生就诊）。使用回归分析探讨了主要结果与患者和手术相关变量之间的关系。
共有 202470 名患者，259677 例手术，在整个疫情期间，与疫情前相比，完成的手术数量减少；在第四波疫情中，完成的手术比例从 COVID-19 前的 79%下降至 67%。在 COVID-19 期间完成手术的患者的等待时间缩短（从 105 天缩短至 69 天）。完成手术和手术等待时间与地理区域、COVID-19 波次以及手术类型和优先级有关。与 COVID-19 前相比，COVID-19 期间所有医疗资源使用指标均下降，医院和全因死亡率上升。
完成的手术比例和已完成手术的等待时间的变化幅度较小，与 COVID-19 波次和手术相关变量有关，这与 COVID-19 期间实施的手术政策一致。医疗资源使用的减少表明 COVID-19 大流行的影响可能是延迟的，并且可能导致许多患者出现需要手术治疗的晚期疾病。
